Asthma as a common pulmonary manifestation in children with ANCA associated vasculitis

Background and aim: The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) have significant morbidity and mortality. Lung involvement is a most common clinical features. This study conducted to review the lung imaging and clinical history of children with ANCA-associated vasculitis. Method: We reviewed retrospectively medical record of patients by ICD-10 ANCA associated vasculitis who admitted between 2013 to 2023. Patients follow up dates, first and last creatinine measurement, proteinuria, chest x ray (CXR) findings, pathology and treatment were extracted. Hyperinflation (as a sign of hyper reactive airway disease) was defined by more than 14 anterior and posterior visible ribs. CXRs were reported by a radiologist. <bold>Results:</bold> A total of 10 children (2 to 16 years, Mean=9.4) included in the study. Eight patients (80%) were male. Follow up dates ranged from 6 to 99 months. C-ANCA was positive in 9 cases. All patients received corticosteroid. Five patients (50%) received cellcept and 3 (33.3%) received plasma phrases. All patients had history of cough, 9 (90%) hyperinflation in CXR, 3 (33.3%) pulmonary hemorrhage. One patient was incubated due to respiratory problem. <bold>Conclusion:</bold> ANCA associated vasculitis may present with a wide range of pulmonary manifestation including interstitial lung disease (ILD), nodules, pleural effusion(P.E), asthma and hyper reactive airway disease. Asthma was the most common pulmonary involvement in our subjects. Keywords:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis, asthma, hyperinflation, Pediatrics