AB0466 Prevalence of systemic vasculitis in various organs – a comparative postmortem study of 36 rheumatoid arthritis and 11 progessive systemic sclerosis patients
Authors: M. Bély, Á. Apáthy
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Objectives</h3> The <b>aim</b> of this study was to compare the <b>incidence</b> and <b>severity</b> of systemic vasculitis (<b>SV</b>) <b>in various organs</b> of rheumatoid arthritis (<b>RA</b>) and progressive systemic sclerosis (<b>SSc</b>) patients. <h3>Methods</h3> Twelve organs (heart, lung, liver, spleen, kidneys, pancreas, gastrointestinal tract, adrenal glands, skeletal muscle, peripheral nerve, skin and brain) of <b>36 RA</b> and <b>11 SSc</b> patients with <b>SV</b> were studied. <b>RA</b> and <b>SSc</b> were confirmed clinically according to the criteria of the <b>ACR</b>. <b>SV</b> and the average value of <b>vasculitis</b> (incidence and severity) <b>in various organs</b> were determined histologically. The "<b>incidence</b>" of vasculitis <b>in various organs</b> was determined based on the presens of vasculitis in blood vessels of different sizes. The "<b>severity</b>" of vasculitis <b>in various organs</b> was evaluated by semi-quantitative, visual estimation on a 0 to 3 plus scale (based on the number of involved vessels/light microscopic field x40). <b>Results: SV</b> was observed in all of <b>36 RA</b> and <b>11 SSc</b> patients with variable incidence and severity. The average value of incidence and severity/organ in <b>SSc</b> was appreciably higher than that of <b>RA</b>. In <b>RA</b> patients, not all investigated organs were involved with SV and the prevalence of blood vessels with vasculitis in each organ was different. In <b>SSc</b> patients <b>SV</b> was present in each of the investigated organs, but with different incidence and severity. <h3>Conclusions</h3> The incidence and severity of vasculitis in various organs of <b>RA</b> and <b>SSc</b> patients were different. Incidence and severity of vasculitis are different aspects of the same pathological process usually running parallel in both autoimmune diseases. In <b>RA</b> the heart, skeletal muscle, pancreas, lung, kidneys and gastrointestinal tract were most markedly involved, while in <b>SSc</b> the kidneys, spleen, lung, pancreas, heart and gastrointestinal tract were. The mortality of <b>RA</b> and <b>SSc</b> basically depended on the location of vasculitis. In <b>RA</b> the <b>SV</b> was lethal in sequence of severity, by involvement of the heart, lung and kidneys, whereas in <b>SSc</b> it was by involvement of the kidneys, lung and heart, respectively. In <b>RA</b> patients mortality was not influenced by the relatively high prevalence of <b>SV</b> in skeletal muscle, pancreas and G-I tract or in <b>SSc</b> patients by <b>SV</b> in the spleen, pancreas, and G-I tract. In <b>RA</b> easily available sites of biopsy for the histological diagnosis of <b>SV</b> are the sural nerve with surrounding skeletal muscle (1) and in <b>SSc</b> it is the frequently involved G-I tract. <h3>References: Apáthy Á, Bély M</h3> Diagnosis of Systemic Vasculitis in Rheumatoid Arthritis: Biopsy of Skeletal Muscle in Combination with Sural Nerve is Optimal - A Retrospective Clinicopathologic Study of <b>161</b> Autopsy Patients. Ann Rheum Dis 2010;69:222 http://www.abstracts2view.com/eular/ <b>Disclosure of Interest</b>: None Declared