The joint ınvolvement pattern of granulomatous polangiitis changed? Multicenter study.

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Granulomatosis with polyangiitis (GPA), a form of anti-neutrophil cytoplasm antibody-associated vasculitis (AAV), is characterized by necrotizing, granulomatous inflammation.
• Musculoskeletal involvement, particularly arthritis, affects a significant proportion of GPA patients, with varied presentation patterns.

Purpose of the Study:

• To investigate the frequency and pattern of joint involvement in GPA, focusing on initial presentations.
• To highlight the potential for symmetrical polyarthritis as a common initial manifestation of GPA, which may differ from previously recognized patterns.

Main Methods:

• Retrospective analysis of 56 patients diagnosed with GPA who initially presented with inflammatory arthritis.
• Inclusion of a control group of 100 GPA patients with similar demographics for comparison.

Main Results:

• Polyarthritis was the most common presentation (57.1%), followed by oligoarthritis (37.5%) and monoarthritis (5.4%).
• The most frequently affected joints included the wrist (66.1%), ankle (53.6%), and metacarpophalangeal joints (44.6%).
• Symmetrical and polyarticular joint involvement was a prominent feature in the studied cohort.

Conclusions:

• Symmetrical polyarthritis may be a more frequent initial presentation of GPA than previously recognized.
• Detailed reporting of joint involvement patterns in large GPA series is crucial for accurate diagnosis and comparison.
• Recognizing arthritis patterns, especially symmetrical polyarthritis, is vital for timely GPA diagnosis and management.