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Anti-neutrophil cytoplasmic antibodies-associated vasculitis: a guide and case study

10 December 2020
Clinical
02 December 2020
Volume 29 · Issue 22

Abstract

Vasculitis is a relatively rare and poorly understood condition causing inflammation of the blood vessels, which in turn can affect a patient's respiratory and renal systems. In some cases, ocular involvement can cause loss of sight and hearing loss may also be a red flag for vasculitis, which, if not treated early, can cause complete hearing loss. Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a group comprising granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis (EGP). AAV is fatal if untreated and as increased risk escalates with age, coupled with a decline in renal function, these are the principal predictors of poor outcome. Vital roles for nursing vasculitis patients lie in managing inflammation and pain, as these distressing symptoms are prevalent in the disease. Because of the multiple complications that can occur with vasculitis, treatment-related information is a high priority for these patients. As nurses are well placed to deliver information, value lies in their role in reducing the negative impacts on treatment regimens and compliance that accompany patients' poor insight into their condition.

To help nurses increase their knowledge of vasculitis conditions, this article will discuss vasculitis, with a particular focus on anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV), which comprises granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis (EGP). It will examine the prevalence, causes and clinical symptoms, as well as discuss some of the treatment options available. This discussion will include the case study of a patient seen in clinical practice (Table 1). Because of the multiple complications that can occur with vasculitis, treatment-related information is a high priority for these patients. Nurses are well placed to deliver this to help reduce the negative impacts on treatment regimens and compliance, often problematic in this patient group.

BD=twice daily; OD=once daily; PO=orally; TDS=three times daily

The term vasculitis refers to a relatively rare and poorly understood set of conditions, causing inflammation of the blood vessels, and AAV is a sub-group within this collection (Ball et al, 2014). According to guidance from the National Institute for Health and Care Excellence (NICE) (2014), the majority of AAV affects small- and medium-sized blood vessels, commonly in the respiratory system or, as in the case of the patient described in this article, the renal system.

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Anti-neutrophil cytoplasmic antibodies-associated vasculitis, AAV
Granulomatosis with polyangiitis
Microscopic polyangiitis
Eosinophilic granulomatosis
Vasculitis