Serological Features of Neurological Involvement in ANCA-associated Vasculitis and Their Predictive Value for Prognosis

Chunrong YAO; Danqing HUANG; Yini KE

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Chunrong YAO, Danqing HUANG, Yini KE. Serological Features of Neurological Involvement in ANCA-associated Vasculitis and Their Predictive Value for Prognosis[J]. Journal of Kunming Medical University.

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Chunrong YAO, Danqing HUANG, Yini KE. Serological Features of Neurological Involvement in ANCA-associated Vasculitis and Their Predictive Value for Prognosis[J]. Journal of Kunming Medical University.

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Serological Features of Neurological Involvement in ANCA-associated Vasculitis and Their Predictive Value for Prognosis

1.
Department of Rheumatology and Immunology，The First People’s Hospital of Guangyuan City，Guangyuan Sichuan 628017
2.
Department of Rheumatology and Immunology，Pujiang Branch of the First Affiliated Hospital，School of Medicine，Zhejiang University，Jinhua Zhejiang 322200
3.
Department of Rheumatology and Immunology，The First Affiliated Hospital，School of Medicine，Zhejiang University，Hangzhou Zhejiang 310006 ，China

Received Date: 2025-10-15
Available Online: 2025-12-29

Abstract

Abstract

Objective To explore the relationship between neurological involvement in patients with antineutrophil cytoplasmic antibody （ANCA）-associated vasculitis and the difference of serum levels of perinuclear anti-neutrophil cytoplasmic antibody （p-ANCA）, erythrocyte sedimentation rate （ESR）, myeloperoxidase immunoglobulin G antibodies （MPO-IgG） and C-reactive protein （CRP）, as well as their predictive value for the prognosis. Methods A total of 106 patients with ANCA-associated vasculitis admitted to the First Affiliated Hospital of Zhejiang University School of Medicine from January 2020 to November 2024 were selected and divided into good prognosis group and poor prognosis group according to the prognosis. Propensity score matching （PSM） was used to reduce baseline differences. The positive rate of p-ANCA and the levels of ESR, MPO-IgG antibody and CRP in patients with different prognosis and neurological involvement were compared. Multivariate Logistic regression was used to analyze the relationship between the above indicators and the prognosis of patients, and ROC curve was used to analyze the predictive efficacy of each indicator and combined detection on prognosis. Results The positive rate of p-ANCA and the levels of ESR, MPO-IgG antibody and CRP in the poor prognosis group were significantly higher than those in the good prognosis group （P < 0.05）. The above indexes in patients with neurological involvement were also significantly higher than those in patients without involvement （P < 0.05）. Multivariate logistic regression analysis showed that p-ANCA positive, ESR, MPO-IgG antibody and CRP were independent predictors of prognosis, especially in patients with neurological involvement （greater OR value, P < 0.05）. ROC curve analysis showed that AUC of each single index in predicting prognosis was between 0.675 and 0.780, and AUC of combined prediction was as high as 0.922, which was significantly better than that of single index （P < 0.05）. The combined AUC values were significantly greater than p-ANCA, ESR, MPO-IgG, and CRP alone （Z = 4.813, 3.414, 2.508, 2.291, P < 0.001, P = 0.001, P = 0.012, P = 0.022）. Conclusion The positive rate of p-ANCA and the levels of ESR, MPO-IgG antibody and CRP are closely related to the neurological involvement and poor prognosis in patients with ANCA-associated vasculitis.

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References(22)

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