Rheumatology Advance Access originally published online on August 17, 2004
Rheumatology 2004 43(12):1532-1535; doi:10.1093/rheumatology/keh374
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Rheumatology Vol. 43 No. 12 © British Society for Rheumatology 2004; all rights reserved
PAPER |
Malignancy is increased in ANCA-associated vasculitis
Division of Medical Sciences and 1 Division of Immunology and Infection, The Medical School, University of Birmingham, Birmingham, UK.
Correspondence to: L. Harper. E-mail: l.harper{at}bham.ac.uk
Objective. In the light of previous reports of an association between malignancy and renal vasculitis, we aimed to investigate the association of malignancy in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, either Wegener's granulomatosis (WG) or microscopic polyangiitis (MPA), and compare it with the general population and disease control groups comprising patients with systemic lupus erythematosus (SLE) or Henoch–Schönlein purpura (HSP).
Methods. A retrospective review of 200 consecutive patients with WG or MPA was performed. Malignancies preceding or concurrent with vasculitis were recorded and the incidence of malignancy was compared with those in a population of 129 patients with HSP, 333 patients with SLE and a normal population in the West Midlands of the UK.
Results. Twenty patients had a diagnosis of malignancy, 14 had MPA and six had WG. Patients with ANCA-associated vasculitis had an increased risk of malignancy compared with HSP patients, of whom six patients had malignancy (relative risk 0.85, confidence interval 0.69–1.05; P = 0.034), or SLE patients, of whom five patients had malignancy (relative risk 0.31, 95% confidence interval 0.14–0.7; P<0.0001). The rate of malignancy compared with an age-matched control group was increased in patients with ANCA-associated vasculitis and HSP (ANCA-associated vasculitis, relative risk 6.02, 95% confidence interval 3.72–9.74; HSP, relative risk 5.25, 95% confidence interval 2.4–11.5). The presence of ANCA was not predictive of malignancy.
Conclusion. In conclusion, patients with ANCA-associated vasculitis have an increased risk of preceding or concurrent malignancy.
KEY WORDS: Vasculitis, Renal, Malignancy, Cancer, Wegener's granulomatosis, Henoch–Schönlein purpura
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