Artikel
Differential platelet counts in active versus inactive ANCA-associated vasculitis (AAV) and AAV-patients with systemic infections
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Veröffentlicht: | 12. September 2014 |
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Gliederung
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Background: There is increasing evidence that platelets (PTL) are protagonists of inflammation in addition to their haemostatic role.
The objectives were to correlate platelet counts (PC) in patients with ANCA-associated vasculitis (AAV) to the disease activity and to investigate whether PC might help to discriminate systemic infection from active AAV.
Methods: PC were analysed in patients with AAV during active state and after being in remission. In addition, PC were analysed in AAV patients in remission but with systemic infections. Results were correlated to clinical manifestations, the Birmingham Vasculitis Activity Score (BVAS) and other laboratory findings (i.e. C-reactive Protein (CRP), leucocytes, Procalcitonin) and diagnostic accuracy was calculated with a receiver operating characteristic (ROC) curve.
Results: Platelets were significantly increase in patients granulomatosis with polyangiitis (GPA), (418 ± 162PT/nl; n=69), microscopic polyangiitis (MPA), (353 ± 108 PT/nl; n=24), and eosinophilic granulomatosis with polyangiitis (EGPA), (334 ± 141PT/nl; n=13) during active disease state compared to patients in remission (GPA: 269 ± 73 PT/nl, MPA: 220 ± 68 PT/nl and EGPA: 255 ± 64 PT/nl); (p<0.001). There was a strong correlation of PC in active disease with the BVAS (r= 0.485; p< 0.001). In AAV patients with systemic infections PC were significantly lower (221 ± 75 PT/nl; n=33) compared to patients with active disease (p<0.01). In the ROC curve analysis the area under the curve (AUC) of PC was significantly larger for distinguishing active disease from systemic infection (AUC 0.850) compared to leukocytes (AUC 0.602) or CRP (AUC 0.543), (p< 0.0001).
Conclusion: PLT correlate with the disease activity and may thus represent immunologic activity in AAV. In addition PC may help to distinguish systemic infections from active disease.