Поступила в редакцию: 19 января 2025 г.
Принята к публикации: 4 марта 2025 г.
Опубликована online: 28 марта 2025 г.
УДК 616.24-001/.131.14-002
DOI: 10.26212/2227-1937.2025.47.32.015
M. T. Abdullayeva1,2
1 Research Institute of Cardiology and Internal Diseases of the Ministry of Health of the Republic of Kazakhstan,
Almaty, the Republic of Kazakhstan
2 Asfendiyarov Kazakh National Medical University,
Almaty, the Republic of Kazakhstan
FEATURES OF LUNG DAMAGE IN ANCA-ASSOCIATED VASCULITIS
Introduction. Systemic vasculitis is a large area of disease characterized by the induction of inflammation in the vessel wall
due to various immune disorders. The formation of anti-neutrophil cytoplasmic antibodies which determine the development
of the so-called anti-neutrophil cytoplasmic antibodies-associated vasculitis is of the variants of such disorders: microscopic
polyangiitis, granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis) and eosinophilic
granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome). These features determine the exceptional
importance of understanding their pathologic behaviour, clinical picture, and treatment, which will be discussed in this
article
Objectives: The main goal of the article is to investigate the frequency of lung damage in patients with ANCA-SV, to assess
their impact on the course, and to adequately select immunosuppressive therapy that allows for achieving disease remission.
To identify the incidence of lung damage in patients with ANCA-SV.
To track the dynamics of pulmonary function indicators and outcomes of ANCA-SV under the treatment.
Material and methods: To do this, we conducted a retrospective analysis of the medical records of 50 patients with a clinical
diagnosis of ANCA-SV who were treated in the Department of Internal Medicine No. 2 of the Research Institute of Cardiology
and Internal Diseases in Almaty, the Republic of Kazakhstan, through 2015 to 2024. The diagnosis was verified based on a life
history, physical examination, immunological study (detection of ANCA), as well as by assessing kidney function indicators
(creatinine, urea, electrolytes, the presence of proteins, diuresis volume), assessing pulmonary function indicators
(spirography, peakflowmetry), instrumental survey such as CT scan of the chest, MRI of the brain, sinuses.
Results and discussion.
29 women and 21 men aged 25 to 75 (average 50 years) were identified among those suffering from ANCA-SV. Our goal was
to investigate the incidence of lung damage in patients with ANCA-SV. To do this, we have conducted some survey methods.
In most cases, changes in the lungs were confirmed by clinical data, decreased saturation, laboratory parameters (general
sputum analysis, sputum culture for MTB and GeneXpert), and results of an immunological blood test: enzyme multiplied
immunoassay (Immunoglobulin E), CT scan of the chest, сhest X-ray, spirography, blood gases test.
Among 50 patients with ANCA-SV, changes in the lungs were detected in 28 patients. Changes in the lungs with ANCA-SV are
different. Some patients experience more than two changes in the lungs.
Conclusions: Lung damage in the form of infiltrates, cavities of destruction, diffuse alveolar damage, interstitial fibrosis,
pleurisy and bronchial asthma, destructive processes, ventilation disorders, changes in the lungs in the form of granulomas,
pulmonary hemorrhages are symptoms of ANCA-SV. Timely hospitalization and modern diagnostic methods make it possible
not only to determine the causes of pulmonary complications in the shortest possible time but also to begin therapy as
quickly as possible and obtain a positive clinical response to treatment. ANCA-associated vasculitis is a difficult condition to
diagnose, which is characterized by a high rate of progression, and malignancy and leads to the death of the patient in a short
time. However, advances in medicine and pharmacology with the discovery of genetically engineered biological therapy
(Rituximab) have improved the prognosis for patients.
Keywords: systemic vasculitis: lung damage, microscopic polyangiitis, Wegener’s disease, Churg-Strauss syndrome
