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Are classification criteria for vasculitis useful in clinical practice?

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Are classification criteria for vasculitis useful in clinical practice?

Observations and lessons from Colombia

Published: 27 February 2009

Journal of Autoimmune Diseases 2009, 6:1 doi:10.1186/1740-2557-6-1

Authors: Paúl Alejandro Méndez Patarroyo1, José Félix Restrepo2, Samanda Adriana Rojas1, Federico Rondón3, Eric L Matteson*4 and Antonio Iglesias-Gamarra5

Introduction: Idiopathic systemic vasculitis represents a group of clinical entities having nonspecific etiology with the common characteristic of acute or chronic inflammatory compromise of the small and large vessels walls, associated with fibrinoid necrosis.

Objectives: To describe the most common inflammatory vascular diseases in a long historical cohort of patients from San Juan de Dios Hospital located in Bogota, Colombia using two different systems and a clinical histopathological correlation format, and to make a comparison between them.

Methods: We reviewed all previously ascertained cases of vasculitis confirmed by biopsy processed between 1953 and 1990, and systematically collected data on all new cases of vasculitis from 1991 to 1997 at the Hospital San Juan de Dios (Bogota – Colombia). The cases were classified in accordance with the Chapel Hill Consensus criteria, and the system proposed by J.T. Lie.

Results: Of 165,556 biopsy tissue specimens obtained during this period from our hospital, 0.18% had vasculitis, perivasculitis or vasculopathy. These included 304 histopathological biopsies from 292 patients. Cutaneous leukocytoclastic vasculitis (64 histological specimens) was the most frequently encountered type of “primary” vasculitis followed by thromboangiitis obliterans (38 specimens), and polyarteritis nodosa (24 specimens). Vasculitis associated with connective tissue diseases (33 specimens) and infection (20 specimens) were the main forms of secondary vasculitis, a category that was omitted from the Chapel Hill consensus report. We found that 65.8% of our histopathological diagnoses could not be classified according to the Chapel Hill classification, and 35.2% could not be classified according to the classification of Lie. Only 8.9% of cases remained unclassified by our system after clinical and histological correlation.

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2016-07-13T16:29:04+01:00 2009-11-13|Categories: Arquivo|