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42. Kongress der Deutschen Gesellschaft für Rheumatologie, 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie, 24. Wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie

17.-20. September 2014, Düsseldorf

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Differential platelet counts in active versus inactive ANCA-associated vasculitis (AAV) and AAV-patients with systemic infections

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  • Peter Willeke - Universitätsklinikum Münster, Medizinische Klinik D, Sektion Rheumatologie und Klinische Immunologie, Münster
  • Heidemarie Becker - Universitätsklinikum Münster, Medizinische Klinik D, Sektion Rheumatologie und Klinische Immunologie, Münster
  • Armend Limani - Universitätsklinikum Münster, Medizinische Klinik D, Sektion Rheumatologie und Klinische Immunologie, Münster
  • Heiko Schotte - Universitätsklinikum Münster, Medizinische Klinik D, Sektion Rheumatologie und Klinische Immunologie, Münster
  • Bernhard Schlüter - Universitätsklinikum Münster, Westfälische Wilhelms-Universität, Centrum für Laboratoriumsmedizin, Münster
  • Annett M. Jacobi - Universitätsklinikum Münster, Westfälische Wilhelms-Universität, Innere Medizin D, Rheumatologie und Klinische Immunologie, Münster

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 42. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 24. wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Düsseldorf, 17.-20.09.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocVK.15

doi: 10.3205/14dgrh249, urn:nbn:de:0183-14dgrh2495

Published: September 12, 2014

© 2014 Willeke et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

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.