Validation of the classification criteria for cryoglobulinaemic vasculitis

The aim of this study was to validate the classification criteria for cryoglobulinaemic vasculitis (CV). Twenty-three centres were involved. New patients with CV (group A) and controls, i.e. subjects with serum cryoglobulins but lacking CV based on the gold standard of clinical judgment (group B) an...

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Published in:Rheumatology (Oxford, England) England), 2014-12, Vol.53 (12), p.2209-2213
Main Authors: Quartuccio, Luca, Isola, Miriam, Corazza, Laura, Ramos-Casals, Manuel, Retamozo, Soledad, Ragab, Gaafar Mohamed, Zoheir, Mostafa Naguib, El-Menyawi, Manal Abdel-Moneim, Salem, Mohamed Nabil, Sansonno, Domenico, Ferraccioli, Gianfranco, Gremese, Elisa, Tzioufas, Athanasios, Voulgarelis, Michael, Vassilopoulos, Dimitris, Scarpato, Salvatore, Pipitone, Nicolò, Salvarani, Carlo, Guillevin, Loic, Terrier, Benjamin, Cacoub, Patrice, Filippini, Davide, Saccardo, Francesco, Gabrielli, Armando, Fraticelli, Paolo, Sebastiani, Marco, Tomsic, Matija, Tavoni, Antonio, Mazzaro, Cesare, Pioltelli, Pietro, Nishimoto, Norihiro, Scaini, Patrizia, Zignego, Anna Linda, Ferri, Clodoveo, Monti, Giuseppe, Pietrogrande, Maurizio, Bombardieri, Stefano, Galli, Massimo, De Vita, Salvatore
Format: Article
Language:English
Subjects:
Adult
Aged
Case-Control Studies
Cryoglobulinemia - classification
Cryoglobulinemia - complications
Cryoglobulinemia - diagnosis
Female
Hepatitis C - complications
Humans
Male
Middle Aged
Sensitivity and Specificity
Surveys and Questionnaires
Systemic Vasculitis - classification
Systemic Vasculitis - diagnosis
Systemic Vasculitis - etiology
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Summary:The aim of this study was to validate the classification criteria for cryoglobulinaemic vasculitis (CV). Twenty-three centres were involved. New patients with CV (group A) and controls, i.e. subjects with serum cryoglobulins but lacking CV based on the gold standard of clinical judgment (group B) and subjects without cryoglobulins but with clinical features that can be observed in the course of CV (group C), were studied. Positivity of serum cryoglobulins was necessary for CV classification. Sensitivity and specificity of the criteria were calculated by comparing group A vs group B. The group A vs group C comparison was done to demonstrate the possible diagnostic utility of the criteria. The study included 268 patients in group A, 182 controls in group B and 193 controls in group C (small vessel vasculitis, 51.8%). The questionnaire (at least 2/3 positive answers) showed 89.0% sensitivity and 93.4% specificity; the clinical item (at least 3/4 clinical involvement) showed 75.7% sensitivity and 89.0% specificity and the laboratory item (at least 2/3 laboratory data) showed 80.2% sensitivity and 62.4% specificity. The sensitivity and specificity of the classification criteria (at least 2/3 positive items) were 89.9% and 93.5%, respectively. The comparison of group A with group C demonstrated the clinical utility of the criteria in differentiating CV from CV mimickers. Classification criteria for CV were validated in a second, large, international study confirming good sensitivity and specificity in a complex systemic disease.
ISSN:1462-0324
1462-0332
DOI:10.1093/rheumatology/keu271