CHEST Guidelines-Pleuritis-and-Pericarditis-in-Antineutrophil-Cytop

Pleuritis-and-Pericarditis-in-Antineutrophil-Cytop

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The document discusses a study on the frequency and characteristics of pleuritis and pericarditis in patients with Antineutrophil Cytoplasmic Autoantibody (ANCA)-associated vasculitis (AAV). AAV includes conditions like granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA).<br /><br />Traditionally, pleural and pericardial involvement is well-known in EGPA but considered rare in GPA and MPA. This study, utilizing a database of 1,830 patients with confirmed AAV from Mayo Clinic, aimed to evaluate the frequency of pleuritis and/or pericarditis among these conditions. It found that 8.3% of patients with GPA, 10.1% with MPA, and 17.4% with EGPA experienced these manifestations. Pericarditis was particularly more frequent in EGPA compared to other AAV forms.<br /><br />Pleural or pericardial inflammation was often a presenting feature of AAV in 81.4% of patients with such manifestations, indicating these involvements can be common initial indicators of the disease. Despite being underrecognized, pleuritis and pericarditis require consideration in differential diagnoses when encountering unexplained pleural or pericardial conditions. Proper diagnosis and immunosuppressive treatment can prevent significant morbidity associated with missed AAV diagnoses.<br /><br />The study involved comprehensive data analysis, including demographic details, clinical presentations, and treatment responses. It found that, with treatment, recurrence of pleuritis or pericarditis was rare. This large-scale research supports the notion that awareness of such manifestations can lead to more timely diagnosis and treatment of AAV, thereby reducing potential end-organ damage.<br /><br />Overall, this research highlights the importance of considering all forms of AAV in patients with pleuritis or pericarditis to avoid disease progression and improve patient outcomes.

Keywords

ANCA-associated vasculitis

pleuritis

pericarditis

granulomatosis with polyangiitis

microscopic polyangiitis

eosinophilic granulomatosis

Mayo Clinic study

disease manifestation

immunosuppressive treatment

differential diagnosis