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Related Concept Videos

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...

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Updated: May 18, 2026

Characterization of Vascular Morphology of Neovascular Age-Related Macular Degeneration by Indocyanine Green Angiography
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Published on: August 11, 2023

Damage assessment in ANCA-associated vasculitis.

Kuljeet Bhamra1, Raashid Luqmani

  • 1Nuffield Orthopaedic Centre, Windmill Road, Oxford, OX3 7HE, UK.

Current Rheumatology Reports
|September 18, 2012
PubMed
Summary

Antineutrophil cytoplasm antibody associated vasculitis is now a chronic condition. Monitoring disease damage, not just activity, is crucial for predicting outcomes and guiding treatment in long-term vasculitis management.

Area of Science:

  • Rheumatology
  • Immunology
  • Internal Medicine

Background:

  • Antineutrophil cytoplasm antibody (ANCA)-associated vasculitis has shifted from life-threatening to chronic relapsing disease due to immunosuppressive therapy.
  • Survival rates have improved significantly, with over 70% 5-year survival, making long-term management critical.

Purpose of the Study:

  • To emphasize the importance of monitoring both active inflammation and chronic damage in ANCA-associated vasculitis.
  • To highlight the prognostic value of quantifying disease damage using tools like the Vasculitis Damage Index (VDI).

Main Methods:

  • Review and analysis of existing data on ANCA-associated vasculitis outcomes.
  • Utilizing the Vasculitis Damage Index (VDI) for damage assessment.

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Main Results:

  • Over 80% of patients develop chronic damage, which does not respond to immunosuppression.
  • A VDI score of at least five damage items is associated with a 7- to 11-fold increased mortality risk.
  • Disease damage is a significant predictor of long-term outcomes.

Conclusions:

  • Distinguishing disease activity from irreversible damage is vital for appropriate patient management and preventing unnecessary immunosuppression.
  • Future clinical trials should aim to limit accumulating damage, not solely control disease activity.
  • The VDI is a valuable tool for predicting mortality and informing management strategies in vasculitis.