ANCA vasculitis can trigger inflammation in large blood vessels as well as small blood vessels with which the disease is associated, Japanese researchers reported after noting that three patients had developed aortic aneurysm.
These patients had ANCA vasculitis caused by anti-myeloperoxidase (MPO) antibodies. An aneurysm is an enlarged segment of the aorta, the main artery in the body. This makes the aorta prone to rupture, putting patients in a potentially life-threatening situation.
The results contrast with scientists’ opinion that ANCA vasculitis is a disease affecting only small blood vessels. The findings prompted the research team at Nihon University School of Medicine to suggest that doctors also scan patients’ large blood vessels after diagnosing the disease.
Researchers’ article on the results, “Aortic aneurysm as a complication of vasculitis associated with myeloperoxidase-antineutrophil cytoplasmic antibodies”, appeared in the review Open medicine.
The first case of large blood vessels the team encountered was in a 75-year-old man who sought treatment due to worsening kidney disease. Tests showed he had MPO-ANCA antibodies. Since he also had skin signs of vasculitis, doctors diagnosed him with ANCA vasculitis with kidney failure.
He received dialysis and anti-inflammatory treatment, and his signs improved. Four months later, he developed tuberculosis and was treated simultaneously for both conditions.
Eleven months after arriving at the hospital, he developed chest pain. When scanning her chest, doctors found an aortic aneurysm, which was not there during her first exams.
He underwent surgery to correct the enlargement and has not had any complications since. His vasculitis and tuberculosis are both in remission.
A 67-year-old man underwent a checkup after rapidly losing weight due to nausea and a lack of appetite. A chest CT scan revealed an aortic aneurysm. When tests indicated that her kidneys were not functioning properly, doctors performed a series of tests that identified MPO-ANCA. He was also eventually diagnosed with ANCA vasculitis with kidney failure.
The man’s condition improved with anti-inflammatory treatment and aortic surgery.
The third patient was an 86 year old female. Like the others, she showed signs of kidney abnormalities. Doctors discovered she had MPO-ANCA antibodies and an aneurysm.
Her vasculitis improved when it was treated, but because her enlarged aorta did not seem to develop, the doctors chose not to operate on her. Instead, they closely monitored his condition.
Since aortic aneurysms often don’t generate symptoms, researchers said doctors should perform chest scans to make sure patients newly identified with ANCA vasculitis don’t also have enlarged arteries. .