CLINICAL AND IMMUNOLGICAL PROFILE OF VASCULITIS AT A TERTIARY CARE HOSPITAL

Abstract

Background: The vasculitides are a heterogenous group of conditions characterized by blood vessel inflammation and necrosis. Vasculitides are relatively uncommon conditions whose etiology is still poorly understood. Treating vasculitis is as revarding as establishing diagnosis. In the absence of treatment, most of patients will suffer or die. With treatment most of patients improve, many will achieve remission and a few will be cured. Disease classification is the process of categorizing illnesses in a larger framework of medical conditions. The principle of classifying diseases is important for highlighting links between diseases and creating schemes for diagnostic approaches, thus guiding treatment decisions.

Objectives: (i) To study the clinical and immunological profile of vasculitis patients at a tertiary care centre. (ii) To study the relationship between clinical and immunological profile in vasculitis. (iii) To compare the clinical and immunological profile of vasculitis patients with national and international DATA.

Methods: The present hospital based observational study was conducted in the Department of Internal Medicine, SKIMS Srinagar. The study had two parts; Retrospective and prospective. Retrospective part: All patients of vasculitis who were admitted or evaluated in OPD from March 2012 to Sept. 2018, were enrolled for the analysis. Prospective part: All Patients of vasculitis admitted or evaluated in OPD from Oct. 2018 to May 2020 were enrolled for study. Patients were classified as vasculitis if they fulfill ACR / EULAR / EMA / Chapell Hill consensus classification criteria for vasculitis and biopsy.

Results: Our study was an observational study of 77 patients. The data was collected both prospectively 50.6 and retrospectively 49.4 large vessel vasculitis was present in 22%, small vessel vasculitis was present in 50.6% and others were 27.27% among large vessel vasculitis takayasu arteritis was present in 18.2% and superior mesenteric arteritis was present in 2.6% among small vessel vasculitis GPA was present in 28.5% EGPA was present in 5.1% biopsy documented small vessel vasculitis was present in 15.6% MPA in 1.2% among others behcets were present in 7.8% cutaneous vasculitis were present in 5.1%, rheumatoid vasculitis were present in 2.6%, SLE vasculitis was present in 2.6%, CNS vasculitis were present in 2.6%, IgA vasculitis was present in 2.6%, GCA was present in 1.2%, MPA was present in 1.2%, NSAID induced vasculitis was present in 1.2% mean age of study patients was 40.9±15.72 years, our study consisted of  male 42.9%, female 57.1%. 80.5% belonged to rural areas where as 19.5%was from urban areas.

Conclusion: The most common clinical, laboratory and radiological findings were polyarthralgia followed by fever, increased erythrocyte sedimentation rate (ESR) and stenosis, respectively. Because of dangerous consequences of this disease, attention to polyarthralgia, fever and increased ESR, especially in young women may be helpful for physicians to prevent diagnosis delay.