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. 2025 Jun 25;42(2):16537.
doi: 10.36141/svdld.v42i2.16537.

Seasonal variation in incidence and relapse of granulomatosis with polyangiitis: A retrospective cohort study from Central Anatolia

Gülşah Soytürk  1 , Hatice Ecem Konak  1 , Pınar Akyüz Dağlı  1 , Rezan Koçak Ulucaköy  1 , Ebru Atalar  1 , Esra Kayacan Erdoğan  1 , Hakan Babaoğlu  1 , Berkan Armağan  1 , Kevser Orhan  1 , İsmail Dogan  2 , Yüksel Maraş  3 , Ahmet Omma  4 , Şükran Erten  2 , Orhan Küçükşahin  2 , Serdar Can Güven  1
Affiliations

Seasonal variation in incidence and relapse of granulomatosis with polyangiitis: A retrospective cohort study from Central Anatolia

Gülşah Soytürk et al. Sarcoidosis Vasc Diffuse Lung Dis. .

Abstract

Background and aim: The etiology of granulomatosis with polyangiitis (GPA) remains under discussion. This study aims to explore patterns of organ involvement, ANCA antibody profiles, seasonal attack rates, and their interrelationship among patients diagnosed with ANCA-associated vasculitis (AAV) in Central Anatolia, shedding light on its multifactorial etiology involving drugs, genetics and environmental factors.

Methods: We conducted a retrospective study involving patients aged 18 to 65 diagnosed with GPA and receiving care at Ankara Bilkent City Hospital Rheumatology Clinic. Diagnosis criteria followed the 2012 Chapel Hill Consensus Conference guidelines and the 2022 American College of Rheumatology/European Association of Rheumatology Societies classification for AAV. Patient data included demographics, antibody test results, seasons of diagnosis and flare, affected organs, and Birmingham Vasculitis Activity Score (BVAS). Organ involvement was determined based on biopsy findings or established criteria.

Results: Our study included 75 patients, with the majority exhibiting cANCA-IFA positivity (94.7%) and PR3-ANCA ELISA positivity (98.3%). During follow-up, 70.7% experienced their first flare, with 37.7% experiencing a second flare. Lung involvement was most common at diagnosis and during flares, followed by ear-nose-throat and renal involvement. Seasonal analysis revealed peaks in disease onset in March, November, and April, with flares more common in September, May, October, and November. Autumn was the most common season for the first flare.

Conclusions: This study provides novel insights into ANCA-associated vasculitis epidemiology in Central Anatolia. Our findings underscore the intricate seasonal variation and infectious triggers of GPA exacerbations, highlighting the importance of tailored management strategies to mitigate disease flares.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article”.

Figures

Figure 1.
Figure 1.
The Sankey diagram illustrates seasonal transitions across the stages of “Diagnosis,” “First Flare” and “Second Flare.”
See this image and copyright information in PMC

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