|LETTER TO EDITOR
|Year : 2018 | Volume
| 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 Publication||21-Aug-2018|
Prof. Rohini Handa
Indraprastha Apollo Hospitals, New Delhi
Source of Support: None, Conflict of Interest: None
|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
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). 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.,,,,,,,,,,, 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. We have reported six patients of microscopic polyangiitis (MPA) in the 5-year period from 1994 to 1999 from our unit.
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. 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. Pradhan et al. reported 18 cases of MPA from Mumbai. 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. The Indian experience with MPA figured in the IJR supplement on vasculitis.
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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Conflicts of interest
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