Seasonal Influence on Development of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis: A Retrospective Cohort Study Conducted at Multiple Institutions in Japan (J-CANVAS)

Yoshida Yusuke

Nakamoto Naoki

Oka Naoya

Kidoguchi Genki

Hosokawa Yohei

Araki Kei

Ishitoku Michinori

Watanabe Hirofumi

Sugimoto Tomohiro

Mokuda Sho

Kida Takashi

Yajima Nobuyuki

Omura Satoshi

Nakagomi Daiki

Abe Yoshiyuki

Kadoya Masatoshi

Takizawa Naoho

Nomura Atsushi

Kukida Yuji

Kondo Naoya

Yamano Yasuhiko

Yanagida Takuya

Endo Koji

Matsui Kiyoshi

Takeuchi Tohru

Ichinose Kunihiro

Kato Masaru

Yanai Ryo

Matsuo Yusuke

Shimojima Yasuhiro

Nishioka Ryo

Okazaki Ryota

Takata Tomoaki

Ito Takafumi

Moriyama Mayuko

Takatani Ayuko

Miyawaki Yoshia

Ito-Ihara Toshiko

Kawaguchi Takashi

Kawahito Yutaka

Hirata Shintaro

The Journal of Rheumatology

Objective To clarify seasonal and other environmental effects on the onset of antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV).
Methods We enrolled patients with new-onset eosinophilic granulomatosis with polyangiitis (EGPA), microscopic polyangiitis (MPA), and granulomatosis with polyangiitis (GPA) registered in the database of a Japanese multicenter cohort study. We investigated the relationship between environmental factors and clinical characteristics. Seasons were divided into 4 (spring, summer, autumn, and winter), and the seasonal differences in AAV onset were analyzed using Pearson chi-square test, with an expected probability of 25% for each season.
Results A total of 454 patients were enrolled, with a mean age of 70.9 years and a female proportion of 55.5%. Overall, 74, 291, and 89 patients were classified as having EGPA, MPA, and GPA, respectively. Positivity for myeloperoxidase (MPO)-ANCA and proteinase 3 (PR3)-ANCA was observed in 355 and 46 patients, respectively. Overall, the seasonality of AAV onset significantly deviated from the expected 25% for each season (P = 0.001), and its onset was less frequently observed in autumn. In ANCA serotypes, seasonality was significant in patients with MPO-ANCA (P < 0.001), but not in those with PR3-ANCA (P = 0.97). Additionally, rural residency of patients with AAV was associated with PR3-ANCA positivity and biopsy-proven pulmonary vasculitis.
Conclusion The onset of AAV was influenced by seasonal variations and was less frequently observed in autumn. In contrast, the occurrence of PR3-ANCA was triggered, not by season, but by rural residency.

antineutrophil cytoplasmic antibody

antineutrophil cytoplasmic antibody–associated vasculitis

eosinophilic granulomatosis with polyangiitis

granulomatosis with polyangiitis

microscopic polyangiitis

seasonal variation

英語

The Journal of Rheumatology

Copyright © 2023 by the Journal of Rheumatology

This is a pre-copyediting, author-produced PDF of an article accepted for publication in The Journal of Rheumatology following peer review. The definitive publisher-authenticated version Seasonal Influence on Development of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis: A Retrospective Cohort Study Conducted at Multiple Institutions in Japan (J-CANVAS), Yusuke Yoshida et al, The Journal of Rheumatology, September 2023, 50 (9) 1152-1158 is available online at: https://doi.org/10.3899/jrheum.2023-0040.

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[DOI] https://doi.org/10.3899/jrheum.2023-0040 ～の異版である