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 Table of Contents  
Year : 2018  |  Volume : 13  |  Issue : 3  |  Page : 212-213

Comments on: Antineutrophil cytoplasmic autoantibody associated vasculitis-Clinical profile and outcomes

Department of Rheumatology, Indraprastha Apollo Hospitals, New Delhi, India

Date of Web Publication21-Aug-2018

Correspondence Address:
Prof. Rohini Handa
Indraprastha Apollo Hospitals, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/injr.injr_81_18

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How to cite this article:
Handa R. Comments on: Antineutrophil cytoplasmic autoantibody associated vasculitis-Clinical profile and outcomes. Indian J Rheumatol 2018;13:212-3

How to cite this URL:
Handa R. Comments on: Antineutrophil cytoplasmic autoantibody associated vasculitis-Clinical profile and outcomes. Indian J Rheumatol [serial online] 2018 [cited 2022 Nov 28];13:212-3. Available from:

Dear Editor,

I read with interest the study on antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis from Nizam's Institute, Hyderabad, published in the recent issue of the Indian Journal of Rheumatology (IJR).[1] This is an important addition to the literature available on this subject from India.

However, there is a significant omission of the preexisting studies from India in this article. The authors' contention that only three clinical studies exist on ANCA associated vasculitis from India is not correct. The first series on granulomatosis with polyangiitis (Wegener's) was reported from the Postgraduate Institute (PGI), Chandigarh, followed by AIIMS, New Delhi, and other centers.[2],[3],[4],[5],[6],[7],[8],[9],[10],[11],[12],[13] In a review on vasculitis in India by Joshi and Mittal, Wegener's was the third most common vasculitis in India after Henoch–Schonlein purpura and aortoarteritis.[14] We have reported six patients of microscopic polyangiitis (MPA) in the 5-year period from 1994 to 1999 from our unit.[15]

In addition, there have been studies focusing on serologic aspects. Rajappa reported 76 patients with ANCA-associated vasculitis from Chennai between January 1990 and June 2001.[16] The distribution of vasculitis in this case series published only in abstract form was as follows: Wegener's granulomatosis – 48, MPA – 10, Churg–Strauss – 6, and crescentic glomerulonephritis – 12. ANCA-associated vasculitis accounted for only 0.001% of hospital admissions in the author's hospital. Further details were not provided.[16] Pradhan et al. reported 18 cases of MPA from Mumbai.[17] This study, focusing on serology, included 18 MPA patients who showed a male preponderance with Birmingham Vasculitis Activity Score ranging from 17 to 30. Systemic involvement was seen in 88.9%, lower respiratory tract involvement in 77.8%, and upper respiratory tract in only 33.3% of cases. Treatment and outcome details were not available in this publication. In another serologic study from Sanjay Gandhi PGI from Lucknow, the authors tried to define the optimum ANCA cutoff values that distinguish between the patient and healthy individual in Indian population.[18] The Indian experience with MPA figured in the IJR supplement on vasculitis.[19]

To avoid citation gaps, especially in a literature search on studies from India, it might be worthwhile to hand-search journals and also employ IndMED, which is a database covering nearly 100 prominent peer-reviewed Indian biomedical journals indexed from 1985 onward. This is part of an Indian Council of Medical Research-funded project – “National Databases of Indian Medical Journals.” Another resource produced under this project is a portal of full-text articles (MedIND) of select Indian medical journals indexed in IndMED or PubMed. Publications in journals not indexed with PubMed and journals, where names have changed like the Journal of Indian Rheumatology Association, now named IJR, may not be electronically retrievable. Hand-search of the journals may also be required in these instances.

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  References Top

Nunna KD, Devarasetti PK, Prasad Irlapati RV, Rajasekhar L. Anti-neutrophil cytoplasmic autoantibodies associated vasculitis – Clinical profile and outcomes. Indian J Rheumatol 2018;13:95-100.  Back to cited text no. 1
  [Full text]  
Singh S, Sakhuja V, Rajwanshi A, Chugh KS. Gastrointestinal tract involvement in Wegener's granulomatosis. J Assoc Physicians India 1985;33:180-1.  Back to cited text no. 2
Bambery P, Sakhuja V, Gupta A, Behera D, Kaur U, Bhusnurmath SR, et al. Wegener's granulomatosis in North India. An analysis of eleven patients. Rheumatol Int 1987;7:243-7.  Back to cited text no. 3
Dayal AK, Joyce P, Alan G, Kurien T, Seshadri MS, Cherian AM, et al. Limited Wegener's granulomatosis. J Assoc Physicians India 1987;35:601-3.  Back to cited text no. 4
Malaviya AN, Kumar A, Singh YN, Singh RR, Dash SC, Khare SD, et al. Wegener's granulomatosis in India: Not so rare. Br J Rheumatol 1990;29:499-500.  Back to cited text no. 5
Bambery P, Sakhuja V, Bhusnurmath SR, Jindal SK, Deodhar SD, Chugh KS, et al. Wegener's granulomatosis: Clinical experience with eighteen patients. J Assoc Physicians India 1992;40:597-600.  Back to cited text no. 6
Kumar A, Pandhi A, Menon A, Sharma SK, Pande JN, Malaviya AN, et al. Wegener's granulomatosis in India: Clinical features, treatment and outcome of twenty-five patients. Indian J Chest Dis Allied Sci 2001;43:197-204.  Back to cited text no. 7
Handa R, Wali JP, Biswas A, Aggarwal P, Wig N. Wegener's granulomatosis A clinicopathologic study. J Assoc Phys India 1997;45:536-9.  Back to cited text no. 8
Singh YP, Sarma PK, Agarwal V, Lawrence A, Aggarwal A, Misra R. Wegener's granulomatosis: Experience at a tertiary care centre. Ind J Rheumatol 2007;3Suppl:S5-28.  Back to cited text no. 9
Chandrasekaran AN, Venugopal B, Porkodi R, Ramakrishnan S, Rajendran CP, Radhakrishna B, et al. Spectrum of clinical and immunological features of systemic rheumatic disorders in a referral tropical hospital in South India: Vasculitides. J Indian Rheum Assoc 1995;3:84-92.  Back to cited text no. 10
Samant R, Vaidya SS, Nadkar MY, Borges NE. Spectrum of clinical features of vasculitides in a referral hospital from Western India. J Indian Rheum Assoc 1997;5:69-74.  Back to cited text no. 11
Mohan A, Kumar A, Gupta R, Singh PV, Singal VK, Guleria R. Relapse in Wegener's granulomatosis. J Indian Rheum Assoc 1997;5:30-4.  Back to cited text no. 12
Biswas J, Babu K, Gopal L, Krishnakumar S, Suresh S, Ramakrishnan S, et al. Ocular manifestations of Wegener's granulomatosis. Analysis of nine cases. Indian J Ophthalmol 2003;51:217-23.  Back to cited text no. 13
[PUBMED]  [Full text]  
Joshi VR, Mittal G. Vasculitis – Indian perspective. J Assoc Physicians India 2006;54Suppl:12-4.  Back to cited text no. 14
Handa R, Wali JP, Gupta SD, Dinda AK, Aggarwal P, Wig N, et al. Classical polyarteritis nodosa and microscopic polyangiitis – A clinicopathologic study. J Assoc Physicians India 2001;49:314-9.  Back to cited text no. 15
Rajappa M. Assessment of activity and damage in ANCA-associated vasculitis in India. Arthritis Res 2002;4 Suppl 1:88.  Back to cited text no. 16
Pradhan VD, Badakere SS, Pawar AR, Almeida AF. Anti-myeloperoxidase antibodies in patients with microscopic polyangiitis. Indian J Med Sci 2003;57:479-86.  Back to cited text no. 17
[PUBMED]  [Full text]  
Ghosh P, Dwivedi S, Misra R, Agarwal V. Determining the prevalence of antineutrophil cytoplasmic antibody and the cut-offs of anti-PR3 and anti-MPO antibody in general population. Indian J Rheumatol 2012;7:209-14.  Back to cited text no. 18
  [Full text]  
Handa R. Polyarteritis nodosa and microscopic polyangiitis – The Indian experience. Indian J Rheumatol 2015;10:s72-7.  Back to cited text no. 19

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[Pubmed] | [DOI]


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