RT Journal Article
SR Electronic
T1 EULAR points to consider in the development of classification and diagnostic criteria in systemic vasculitis
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 1744
OP 1750
DO 10.1136/ard.2009.119032
VO 69
IS 10
A1 Basu, Neil
A1 Watts, Richard
A1 Bajema, Ingeborg
A1 Baslund, Bo
A1 Bley, Thorsten
A1 Boers, Maarten
A1 Brogan, Paul
A1 Calabrese, Len
A1 Cid, Maria C
A1 Cohen-Tervaert, Jan Willem
A1 Flores-Suarez, Luis Felipe
A1 Fujimoto, Shouichi
A1 de Groot, Kirsten
A1 Guillevin, Loic
A1 Hatemi, Gulen
A1 Hauser, Thomas
A1 Jayne, David
A1 Jennette, Charles
A1 Kallenberg, Cees G M
A1 Kobayashi, Shigeto
A1 Little, Mark A
A1 Mahr, Alfred
A1 McLaren, John
A1 Merkel, Peter A
A1 Ozen, Seza
A1 Puechal, Xavier
A1 Rasmussen, Niels
A1 Salama, Alan
A1 Salvarani, Carlo
A1 Savage, Caroline
A1 Scott, David G I
A1 Segelmark, Mårten
A1 Specks, Ulrich
A1 Sunderköetter, Cord
A1 Suzuki, Kazuo
A1 Tesar, Vladimir
A1 Wiik, Allan
A1 Yazici, Hasan
A1 Luqmani, Raashid
YR 2010
UL http://ard.bmj.com/content/69/10/1744.abstract
AB Objectives The systemic vasculitides are multiorgan diseases where early diagnosis and treatment can significantly improve outcomes. Robust nomenclature reduces diagnostic delay. However, key aspects of current nomenclature are widely perceived to be out of date, these include disease definitions, classification and diagnostic criteria. Therefore, the aim of the present work was to identify deficiencies and provide contemporary points to consider for the development of future definitions and criteria in systemic vasculitis. Methods The expert panel identified areas of concern within existing definitions/criteria. Consequently, a systematic literature review was undertaken looking to address these deficiencies and produce ‘points to consider’ in accordance with standardised European League Against Rheumatism (EULAR) operating procedures. In the absence of evidence, expert consensus was used. Results There was unanimous consensus for re-evaluating existing definitions and developing new criteria. A total of 17 points to consider were proposed, covering 6 main areas: biopsy, laboratory testing, diagnostic radiology, nosology, definitions and research agenda. Suggestions to improve and expand current definitions were described including the incorporation of anti-neutrophil cytoplasm antibody and aetiological factors, where known. The importance of biopsy in diagnosis and exclusion of mimics was highlighted, while equally emphasising its problems. Thus, the role of alternative diagnostic tools such as MRI, ultrasound and surrogate markers were also discussed. Finally, structures to develop future criteria were considered. Conclusions Limitations in current classification criteria and definitions for vasculitis have been identified and suggestions provided for improvement. Additionally it is proposed that, in combination with the updated evidence, these should form the basis of future attempts to develop and validate revised criteria and definitions of vasculitis.