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Provisional seven-item criteria for the diagnosis of polyarteritis nodosa.
Rheumatology International ( IF 3.2 ) Pub Date : 2020-02-27 , DOI: 10.1007/s00296-020-04535-2
Shintaro Yamamoto 1, 2 , Hiroshi Oiwa 1
Affiliation  

Polyarteritis nodosa (PAN) is a potentially life-threatening systemic vasculitis, which predominantly involves medium arteries. However, it may be difficult to diagnose PAN in its early stage. The aim of our study was to investigate the sensitivity and specificity of the American College of Rheumatology (ACR) and the Japanese Ministry of Health, Labour and Welfare (MHLW) criteria for the diagnosis of PAN in a single-centre retrospective cohort in Japan and to develop simplified criteria with favourable diagnostic performance. All patients with “PAN” or “suspicion of PAN,” as indicated on insurance forms, were included. The patient population was classified into PAN and non-PAN groups based on a retrospective chart review. The sensitivity and specificity of the ACR and MHLW criteria were calculated. Items that favourably discriminated the PAN group from the non-PAN group were determined and used as items for our provisional criteria. Thirteen cases of PAN and 24 cases without PAN were included in this study. The sensitivities of the ACR and MHLW criteria were 61.5% (8/13) and 30.8% (4/13), respectively, whereas the specificities were 79.2% (19/24) and 87.5% (21/24), respectively. We developed provisional criteria consisting of seven items, and found that a cut-off of ≥ 4 items had a sensitivity of 92.3% (12/13) and specificity of 91.7% (22/24) (p < 0.000001). The provisional seven-item criteria, developed in our real-world cohort of patients suspected of having PAN, had a high sensitivity and specificity and may be useful in the diagnosis of PAN, although it should be validated in additional patient populations.



中文翻译:

诊断结节性多发性动脉炎的临时七项标准。

结节性多发性动脉炎(PAN)是一种可能威胁生命的系统性血管炎,主要累及中动脉。但是,可能难以在早期诊断PAN。我们的研究目的是调查美国风湿病学院(ACR)和日本厚生劳动省(MHLW)标准在日本和日本的单中心回顾性队列研究中对PAN诊断的敏感性和特异性。开发具有良好诊断性能的简化标准。包括所有在保险单上注明的“ PAN”或“怀疑PAN”的患者。根据回顾性图表回顾,将患者人群分为PAN组和非PAN组。计算了ACR和MHLW标准的敏感性和特异性。确定了将PAN组与非PAN组区分开来的项目,并将其用作我们的临时标准。这项研究包括13例PAN和24例无PAN的病例。ACR和MHLW标准的敏感性分别为61.5%(8/13)和30.8%(4/13),而特异性分别为79.2%(19/24)和87.5%(21/24)。我们制定了由七个项目组成的临时标准,发现临界值≥4个项目的敏感性为92.3%(12/13),特异性为91.7%(22/24)(2%(19/24)和87.5%(21/24)。我们制定了由七个项目组成的临时标准,发现临界值≥4个项目的敏感性为92.3%(12/13),特异性为91.7%(22/24)(2%(19/24)和87.5%(21/24)。我们制定了由七个项目组成的临时标准,发现临界值≥4个项目的敏感性为92.3%(12/13),特异性为91.7%(22/24)(p  <0.000001)。在我们的现实世界中怀疑患有PAN的患者队列中开发的临时七项标准具有很高的敏感性和特异性,尽管可以在其他患者人群中得到验证,但对诊断PAN可能有用。

更新日期:2020-02-27
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