Evaluation of thrombosis frequency in anca-associated vasculitis

Purpose: Antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) is a group of diseases characterized by inflammation of small vessels, which can lead to widespread systemic involvement, shorten life expectancy, and cause deterioration in renal functions. Patients with AAV tend to thrombosis due to increased inflammation and endothelial damage. We aim to examine the incidence of thromboembolism and the risk factors leading to thromboembolism by retrospectively examining our AAV cases in our hospital. Method: Demographic information, clinical, and laboratory findings, treatment data and information about survival of patients diagnosed with AAV followed at Çukurova University Medical Faculty Research Hospital Department of Rheumatology between January 2010 and 2022 were examined retrospectively based on patient files and computer system of our hospital. Results: 65 patients diagnosed with ANCA-associated vasculitis were included in the study. 36 (55.4%) of 65 cases included in the study were female and 29 (44.6%) were male. It was observed that the mean age of the patients was 51.4±14.1 years. Comorbid disease was present in 34 (52.3 %) of the cases. The most common comorbidities are respectively; It was Hypertension in 16 patients and Diabetes Mellitus in 15 patients. Of our 65 cases diagnosed with AAV, 59 (90.77%) had a diagnosis of "Granulomatous Polyangiitis", 4 (6.15%) had a diagnosis of "Eosinophilic Polyangiitis", and 2 (3%) had a diagnosis of " Microscopic Polyangiitis". Arterial and venous thrombosis was detected in 10 (15.4%) patients. Arterial thrombosis was observed in 2 (20%) of these patients and venous thrombosis in 8 (80%) patients. When cases with thrombosis were examined, it was observed that all cases with thrombosis were diagnosed as Granulomatous Polyangiitis. It was determined that there was a significant relationship between smoking and the development of thrombosis (p<0.001). Total protein/albumin ratios were compared between the two groups. This rate was statistically significantly higher in the group that developed thrombosis (p=0.027). As a result of the diagnostic performance tests, we performed to determine the cut-off value; We determined that We found that if the protein/albumin ratio is above 2.18, the risk of thrombosis increases. And we found specificity of the cut-off value was %83,4, the sensitivity was 70%. Discussion and Conclusion: There is an increased risk of thromboembolism in patients with AAV. Although the main reasons for this are increased inflammation and endothelial damage, cyclophosphamide and corticosteroid treatments can also increase risk of thrombosis. We believe that especially in the presence of factors that may increase the tendency to thrombosis, such as smoking, it is necessary to be more careful and to guide these patients to quit smoking. The prophylactic administration of anticoagulants to AAV patients is controversial. Randomized controlled studies are needed to determine which patients will be given anticoagulants, which anticoagulant will be selected and this treatments duration. Key words: ANCA-associated vasculitis, thromboembolism, smoking