DOI QR코드

DOI QR Code

혈관염의 새로운 분류기준

Update on the Classification Criteria for Vasculitis

  • 김혜원 (을지대학교 의과대학 을지병원 류마티스 내과) ;
  • 허진욱 (을지대학교 의과대학 을지병원 류마티스 내과)
  • Kim, Hye Won (Division of Rheumatology, Department of Internal Medicine, Eulji University College of Medicine, Eulji General Hospital) ;
  • Hur, Jin-Wuk (Division of Rheumatology, Department of Internal Medicine, Eulji University College of Medicine, Eulji General Hospital)
  • 발행 : 2014.10.01

초록

The systemic vasculitides are a group of diverse diseases characterized by blood vessel inflammation. The existing classification criteria are intended to create homogeneous patient groups for research and not to diagnose individual patients. However, they have been misused as diagnostic criteria, in both practice and research. The existing classification systems for vasculitis are limited by the overlapping features of disease entities and unrecognized pathogenic mechanisms. This review discusses the benefits and limitations of the widely used American College of Rheumatology criteria and Chapel Hill Consensus Conference nomenclature, updated in 2012. Improved diagnostics, including antineutrophil cytoplasmic antibody (ANCA) testing and imaging, argue for updating the established classification criteria. International efforts are underway to build a more effective classification and diagnostic criteria that reflect a better understanding of the pathophysiology of vasculitis and recent discoveries of genetics and biomarkers.

키워드

참고문헌

  1. Zeek PM. Periarteritis nodosa; a critical review. Am J Clin Pathol 1952;22:777-790. https://doi.org/10.1093/ajcp/22.8.777
  2. Alarcon Segovia D, Brown AL Jr. Classification and etiologic aspects of necrotizing angiitides: an analytic approach to a confused subject with a critical review of the evidence for hypersensitivity in polyarteritis nodosa. Mayo Clin Proc 1964;39:205-222.
  3. DeShazo RD. The spectrum of systemic vasculitis: a classification to aid diagnosis. Postgrad Med 1975;58:78-82. https://doi.org/10.1080/00325481.1975.11714169
  4. Gilliam JN, Smiley JD. Cutaneous necrotizing vasculitis and related disorders. Ann Allergy 1976;37:328-339.
  5. Fauci AS, Haynes B, Katz P. The spectrum of vasculitis: clinical, pathologic, immunologic and therapeutic considerations. Ann Intern Med 1978;89(5 Pt 1):660-676. https://doi.org/10.7326/0003-4819-89-5-660
  6. Lie JT. Nomenclature and classification of vasculitis: plus ca change, plus cest la meme chose. Arthritis Rheum 1994;37:181-186. https://doi.org/10.1002/art.1780370205
  7. Arend WP, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 1990;33:1129-1134.
  8. Calabrese LH, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of hypersensitivity vasculitis. Arthritis Rheum 1990;33:1108-1113.
  9. Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 1990;33:1122-1128.
  10. Lightfoot RW Jr, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum 1990;33:1088-1093.
  11. Masi AT, Hunder GG, Lie JT, et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum 1990;33:1094-1100.
  12. Mills JA, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Henoch-Schonlein purpura. Arthritis Rheum 1990;33:1114-1121.
  13. Leavitt RY, Fauci AS, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis. Arthritis Rheum 1990;33: 1101-1107.
  14. Jennette JC, Falk RJ, Andrassy K, et al. Nomenclature of systemic vasculitides: proposal of an international consensus conference. Arthritis Rheum 1994;37:187-192. https://doi.org/10.1002/art.1780370206
  15. Waller R, Ahmed A, Patel I, Luqmani R. Update on the classification of vasculitis. Best Pract Res Clin Rheumatol 2013;27:3-17.
  16. Ruperto N; Paediatric Rheumatology International Trials Organisation (PRINTO). Classification criteria and diagnostic tests for vasculitides. J Rheumatol 2012;39:1503-1505. https://doi.org/10.3899/jrheum.120640
  17. Ozen S, Ruperto N, Dillon MJ, et al. EULAR/PReS endorsed consensus criteria for the classification of childhood vasculitides. Ann Rheum Dis 2006;65:936-941.
  18. Ozen S, Pistorio A, Iusan SM, et al. EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008: part II: final classification criteria. Ann Rheum Dis 2010;69:798-806. https://doi.org/10.1136/ard.2009.116657
  19. Ruperto N, Ozen S, Pistorio A, et al. EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008: part I: overall methodology and clinical characterisation. Ann Rheum Dis 2010;69:790-797. https://doi.org/10.1136/ard.2009.116624
  20. Lie JT. Illustrated histopathologic classification criteria for selected vasculitis syndromes: American College of Rheumatology Subcommittee on Classification of Vasculitis. Arthritis Rheum 1990;33:1074-1087.
  21. Lie JT. Histopathologic specificity of systemic vasculitis. Rheum Dis Clin North Am 1995;21:883-909.
  22. Yamada I, Nakagawa T, Himeno Y, Kobayashi Y, Numano F, Shibuya H. Takayasu arteritis: diagnosis with breath-hold contrast-enhanced three-dimensional MR angiography. J Magn Reson Imaging 2000;11:481-487. https://doi.org/10.1002/(SICI)1522-2586(200005)11:5<481::AID-JMRI3>3.0.CO;2-4
  23. Yamada I, Nakagawa T, Himeno Y, Numano F, Shibuya H. Takayasu arteritis: evaluation of the thoracic aorta with CT angiography. Radiology 1998;209:103-109. https://doi.org/10.1148/radiology.209.1.9769819
  24. Karahaliou M, Vaiopoulos G, Papaspyrou S, Kanakis MA, Revenas K, Sfikakis PP. Colour duplex sonography of temporal arteries before decision for biopsy: a prospective study in 55 patients with suspected giant cell arteritis. Arthritis Res Ther 2006;8:R116. https://doi.org/10.1186/ar2003
  25. Karassa FB, Matsagas MI, Schmidt WA, Ioannidis JP. Meta-analysis: test performance of ultrasonography for giant-cell arteritis. Ann Intern Med 2005;142:359-369. https://doi.org/10.7326/0003-4819-142-5-200503010-00011
  26. Walter MA, Melzer RA, Schindler C, Müller-Brand J, Tyndall A, Nitzsche EU. The value of [18F]FDG-PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Eur J Nucl Med Mol Imaging 2005;32:674-681. https://doi.org/10.1007/s00259-004-1757-9
  27. Sørensen SF, Slot O, Tvede N, Petersen J. A prospective study of vasculitis patients collected in a five year period: evaluation of the Chapel Hill nomenclature. Ann Rheum Dis 2000;59:478-482. https://doi.org/10.1136/ard.59.6.478
  28. Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013;65:1-11.
  29. Watts R, Lane S, Hanslik T, et al. Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies. Ann Rheum Dis 2007;66:222-227.
  30. Liu LJ, Chen M, Yu F, Zhao MH, Wang HY. Evaluation of a new algorithm in classification of systemic vasculitis. Rheumatology (Oxford) 2008;47:708-712. https://doi.org/10.1093/rheumatology/ken079
  31. Uribe AG, Huber AM, Kim S, et al. Increased sensitivity of the European medicines agency algorithm for classification of childhood granulomatosis with polyangiitis. J Rheumatol 2012;39:1687-1697. https://doi.org/10.3899/jrheum.111352
  32. Abdulkader R, Lane SE, Scott DG, Watts RA. Classification of vasculitis: EMA classification using CHCC 2012 definitions. Ann Rheum Dis 2013;72:1888.
  33. Linder R, Orth I, Hagen EC, van der Woude FJ, Schmitt WH. Differentiation between Wegener's granulomatosis and microscopic polyangiitis by an artificial neural network and by traditional methods. J Rheumatol 2011;38:1039-1047. https://doi.org/10.3899/jrheum.100814
  34. Jayne D, Rasmussen N, Andrassy K, et al. A randomized trial of maintenance therapy for vasculitis associated with antineutrophil cytoplasmic autoantibodies. N Engl J Med 2003;349:36-44. https://doi.org/10.1056/NEJMoa020286
  35. Wegener's Granulomatosis Etanercept Trial (WGET) Research Group. Etanercept plus standard therapy for Wegener's granulomatosis. N Engl J Med 2005;352:351-361. https://doi.org/10.1056/NEJMoa041884
  36. Basu N, Watts R, Bajema I, et al. EULAR points to consider in the development of classification and diagnostic criteria in systemic vasculitis. Ann Rheum Dis 2010;69:1744-1750. https://doi.org/10.1136/ard.2009.119032
  37. Craven A, Robson J, Ponte C, et al. ACR/EULAR-endorsed study to develop Diagnostic and Classification Criteria for Vasculitis (DCVAS). Clin Exp Nephrol 2013;17:619-621. https://doi.org/10.1007/s10157-013-0854-0
  38. Khan I, Watts RA. Classification of ANCA-associated vasculitis. Curr Rheumtol Rep 2013;15:1-6.
  39. Lyons PA, Rayner TF, Trivedi S, et al. Genetically distinct subsets within ANCA-associated vasculitis. N Engl J Med 2012;367:214-223. https://doi.org/10.1056/NEJMoa1108735
  40. Walsh M, Flossmann O, Berden A, et al. Risk factors for relapse of antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheum 2012;64:542-548. https://doi.org/10.1002/art.33361
  41. Xiao H, Ciavatta D, Aylor DL, et al. Genetically determined severity of anti-myeloperoxidase glomerulonephritis. Am J Pathol 2013;182:1219-1226. https://doi.org/10.1016/j.ajpath.2012.12.006