Background Chronic inflammatory diseases, e.g. ANCA-associated vasculitides (AAV), are associated with increased incidence of venous thromboembolism (VTE) that can be asymptomatic in a proportion of patients.
Objectives To evaluate a prevalence of asymptomatic deep vein thrombosis (DVT) in a cohort of AAV patients compared with healthy controls.
Methods We used compression US to study the occurrence of asymptomatic DVT in 99 patients with AAV (67 females and 32 males, average age of 54.0 years, range of 18 to 77), including granulomatosis with polyangiitis (GPA; n=72), microscopic polyangiitis (MPA; n=13) and eosinophilic granulomatosis with polyangiitis (EGPA; n=14), and 514 healthy controls (339 females and 175 males; average age of 54.7 years, range of 17 to 89 years) without signs and symptoms of DVT. Signs of activity of AAV were present in 64 patients.
Results Asymptomatic DVT was detected in 8 (8.1%) of 99 patients with AAV, including 3/72 (4.2%) GPA patients, 3/13 (23.1%) MPA patients and 2/14 (14.3%) EGPA patients. All 8 patients with DVT had active vasculitis. In 6 of 8 patients AAV was diagnosed within 6 months prior to US. A prevalence of traditional VTE risk factors was comparable in patients with and without DVT, but prednisolone dose at the time of US was higher in patients with DVT (38.8 vs 10.8 mg daily, p<0.001). One patient with asymptomatic DVT died within 3 months after US from acute myocardial infarction, and one patient developed postthrombotic syndrome. There were no cases of pulmonary embolism. AAV was associated with significantly increased risk of asymptomatic DVT compared with healthy controls (OR =22.5, CI 4.7 to 107.7). This risk was even higher in patients with active AAV (OR =36.6, CI 7.6 to 174.5).
Conclusions Patients with AAV have a high risk of asymptomatic DVT within 6 months after diagnosis. These data may justify wider screening for DVT in AAV.
Disclosure of Interest None declared
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