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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3790

Title: Plasma Level of von Willebrand Factor Propeptide at Diagnosis: A Marker of Subsequent Renal Dysfunction in Autoimmune Rheumatic Diseases.
Other Titles: 診断時の血漿中von Willebrand因子プロペプチドは自己免疫性リウマチ性疾患における腎機能障害発症の予測因子となる
Authors: Yada, Noritaka
Yoshimoto, Kiyomi
Kawashima, Hiromasa
Yoneima, Ryo
Nishimura, Nobushiro
Tai, Yoshiaki
Tsushima, Emiko
Miyamoto, Makiko
Ono, Shiro
Matsumoto, Masanori
Fujimoto, Takashi
Nishio, Kenji
Keywords: von Willebrand factor propeptide
renal dysfunction
mutimeric analysis
rheumatic disease
Issue Date: 1-Jan-2020
Publisher: Sage Publications
Citation: Clinical and applied thrombosis/hemostasis Vol.26 Article No.1076029620938874 (2020 Jan)
Abstract: Introduction: Patients with systemic autoimmune rheumatic diseases (SARDs) such as rheumatoid arthritis, systemic lupus erythematosus (SLE), Sjögren syndrome, and systemic sclerosis, which are chronic inflammatory diseases, are prone to develop renal dysfunction, which is related to vascular endothelial cell damage. Material and methods: We evaluated plasma levels of von Willebrand factor (VWF), VWF propeptide (VWF-pp), disintegrin-like and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13), and VWF multimer pattern in patients with SARDs at diagnosis and investigated whether they may serve as markers to identify patients destined to develop renal dysfunction within 1 year. Renal dysfunction was defined as subsequent reduced estimated glomerular filtration rate (eGFR) by >25% or the new appearance of abnormal urine findings such as proteinuria (protein > 30 mg/dL) or hematuria (red blood cells >20/HPF in urine sediments). Overall, 63 patients with SARDs were studied. Results and conclusions: We observed a significant increase of VWF-pp and a significant decrease of ADAMTS13 in patients with SARDs compared with normal healthy controls. The highest level of VWF-pp was observed in patients with SLE among the groups. The levels of VWF and multimer pattern of VWF were not different compared with normal healthy controls. Von Willebrand factor propeptide predicted a subsequent decrease in eGFR at a cutoff point of 210% (sensitivity, 78.6%; specificity, 73.5%) and new urinary abnormal findings at a cutoff point of 232% (sensitivity, 77.8%; specificity, 77.8%) Using these cutoff points, multivariable analysis revealed that VWF-pp was a significant risk factor for renal dysfunction at an odds ratio of 8.78 and 22.8, respectively, and may lead to a new therapeutic approach to prevent vasculitis and renal dysfunction.
Description: 博士(医学)・乙第1474号・令和2年9月30日
Copyright © The Author(s) 2020. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
URI: http://hdl.handle.net/10564/3790
ISSN: 10760296
Academic Degrees and number: 24601B1474
Degree-granting date: 2020-09-30
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2020年度

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