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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제59권 제3호
발행연도
2018.1
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397 - 405 (9page)

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Purpose: Delta neutrophil index (DNI) represents the immature granulocytes count associated with neutrophil-consumption. We investigated whether DNI might be associated with Birmingham vasculitis activity score (BVAS) at diagnosis and could predictrelapse during the follow-up in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Materials and Methods: We reviewed the medical records of 97 patients having DNI results. Twenty patients had granulomatosiswith polyangiitis (GPA), 58 had microscopic polyangiitis (MPA), and 19 had eosinophilic GPA (EGPA). We collected clinical andlaboratory data including BVAS, five factor score (FFS), and DNI. The correlation coefficient and cumulative relapse free survival ratewere obtained. The optimal cut-off of DNI was extrapolated by calculating the area under the receiver operator characteristic curve. Results: DNI was significantly related to cross-sectional BVAS. Furthermore, among continuous variables, only DNI could reflectBVAS of GPA and MPA, but not EGPA. Severe AAV was defined as BVAS ≥20 (the highest quartile). At diagnosis, patients havingDNI ≥0.65% had a significantly higher risk of severe GPA and MPA than those having not (relative risk 4.255) at diagnosis. Duringthe follow-up, DNI ≥0.65% could predict the higher relapse rate. Conclusion: DNI could reflect BVAS at diagnosis and furthermore, DNI ≥0.65% could not only identify severe AAV at diagnosis,but also predict relapse during the follow-up in patients with GPA and MPA.

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