Research ArticleOpen AccessGoogle Scholar indexed
Anti-Neutrophil Cytoplasmic Antibody Vasculitis in Pediatric Patients: Is the Incidence Rising?
Department of Pediatrics, Division of Nephrology, Cohen Children’s Medical Center of New York, New York, USA
Department of Pediatrics, Division of Nephrology, Cohen Children’s Medical Center of New York, New York, USA
Department of Pediatrics, Division of Nephrology, Cohen Children’s Medical Center of New York, New York, USA
Department of Pediatrics, Division of Rheumatology, Cohen Children’s Medical Center of New York, New York, USA
Department of Pediatrics, Division of Rheumatology, Cohen Children’s Medical Center of New York, New York, USA
Department of Pathology, North Shore University Hospital of the North Shore—LIJ Health System, New York, USA
Department of Pediatrics, Division of Nephrology, NYU Langone Medical Center, New York, USA
- 1 Department of Pediatrics, Division of Nephrology, Cohen Children’s Medical Center of New York, New York, USA
- 2 Department of Pediatrics, Division of Nephrology, Cohen Children’s Medical Center of New York, New York, USA
- 3 Department of Pediatrics, Division of Nephrology, Cohen Children’s Medical Center of New York, New York, USA
- 4 Department of Pediatrics, Division of Rheumatology, Cohen Children’s Medical Center of New York, New York, USA
- 5 Department of Pediatrics, Division of Rheumatology, Cohen Children’s Medical Center of New York, New York, USA
- 6 Department of Pathology, North Shore University Hospital of the North Shore—LIJ Health System, New York, USA
- 7 Department of Pediatrics, Division of Nephrology, NYU Langone Medical Center, New York, USA
Open Journal of Nephrology·Volume 02 (2012)·Pages 19–22·Published 25 June 2012·DOI10.4236/ojneph.2012.22003
Copy link · social · email
Abstract
Objectives: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune disease usually seen in middle-aged and older adults but which is rare in children and adolescents. We sought to determine if there has been a change in the incidence of this disorder. Methods: Single-center, retrospective review. Results: Over the last 2 years, we have encountered a striking increase in the frequency of this disease in pediatric patients. All eight patients seen during this period had renal involvement and 5 patients rapidly progressed to end stage kidney disease. The prognosis was worse in younger patients, those with microscopic polyangiitis, and those with chronic kidney damage in the diagnostic renal biopsy. Conclusions: We report these observations to highlight this change in the epidemiology of ANCA-associated vasculitis and to promote earlier recognition and treatment of this severe form of glomerulonephritis.
KeywordsAnti-Neutrophil Cytoplasmic Antibody (ANCA)VasculitisEpidemiology
- R. J. Falk and J. C. Charles Jennette, “ANCA Disease: Where Is This Field Heading?” Journal of the American Society of Nephrology, Vol. 21, No. 5, 2010, pp. 745-752. doi:10.1681/ASN.2009121238
- A. E. Berden, F. Ferrario, E. Christian Hagen, D. R. Jayne, J. Charles Jennette, K. Joh, I. Neumann, L. H. No?l, C. D. Pusey, R. Waldherr, J. A. Bruijn and I. M. Bajema, “Histopathologic Classification of ANCA-Associated Glomerulonephritis,” Journal of the American Society of Nephrology, Vol. 21, No. 10, 2010, pp. 1628-1636. doi:10.1681/ASN.2010050477
- C. E. Rodrigues, M. R. Callado, C. A. Nobre, F. E. Moura, R. M. Vieira, L. A. de Albuquerque and W. P. Vieira, “Wegener’s Granulomatosis: Prevalence of the Initial Clinical Manifestations—Report of Six Cases and Review of the Literature,” Revista Brasileira de Reumatologia, Vol. 50, No. 2, 2010, pp. 150-164. doi:10.1590/S0482-50042010000200005
- R. Coppo, P. Cirina, A. Amore, R. A. Sinico, A. Radice and C. Rollino, “Properties of Circulating IgA Molecules in Henoch Schonlein Purpura Nephritis with Focus on Neutrophil Cytoplasmic Antigen IgA Binding (IgAANCA): New Insight into a Debated Issue. Italian Group of Renal Immunopathology Collaborative Study on Henoch Schonlein Purpura in Adults and Children,” Nephrology Dialysis Transplantation, Vol. 12, No. 11, 1997, pp. 2269-2276. doi:10.1093/ndt/12.11.2269
- S. Grisaru, G. W. Yuen, P. M. Miettunen and L. A. Hamiwka, “Incidence of Wegener’s Granulomatosis in Children,” The Journal of Rheumatology, Vol. 37, No. 2, 2010, pp. 440-442. doi:10.3899/jrheum.090688
- D. A. Cabral, A. G. Uribe, S. Benseler, K. M. O’Neil, P. J. Hashkes, G. Higgins, A. S. Zeft, D. J. Lovell, D. J. Kingsbury, A. Stevens, et al., “Classification, Presentation, and Initial Treatment of Wegener’s Granulomatosis in Childhood,” Arthritis Rheum, Vol. 60, No. 11, 2009, pp. 34133424,. doi:10.1002/art.24876
- M. Shimizu, T. Sekiguchi, et al., “A Case of a 6-Year Old Girl with Anti-Neutrophil Cytoplasmic AntibodyNegative Pauci-Immune Crescentic Glomerulonephritis,” Clinical and Experimental Nephrology, Vol. 15, No. 4, 2011, pp. 596-601. doi:10.1007/s10157-011-0423-3
- R. Kain, M. Exner, R. Brandes, et al., “Molecular Mimicry in Pauci-Immune Focal Necrotizing Glomerulonephritis,” Nature Medicine, Vol. 14, No. 10, 2008, pp. 1088-1096. doi:10.1038/nm.1874
- A. J. Roth, M. C. Brown, R. N. Smith, A. K. Badwar, et al., “Anti-LAMP-2 Antibodies Are Not Prevalent in Patients with Antineutrophil Cytoplasmic Autoantibody Glomerulonephritis,” Journal of the American Society of Nephrology, Vol. 23, No. 5, 2012, pp. 545-555.