Analysis of Treatment Influence on Kidney Function and Brain Non-Contrast MRI Vascular Manifestations of Systemic ANCA-Associated Vasculitis with Renal Involvement

Q: What clinical and imaging outcomes were evaluated after AAV treatment?

The study assessed clinical, neurological, and renal function changes and performed brain MRI to quantify vascular and vasogenic alterations over follow-up.

Q: How did treatment affect cerebral vascular alterations in patients?

Compared with baseline, treatment was associated with a significant reduction in the occurrence of vascular dilatation and narrowing in secondary and tertiary cerebral vascular branches.

Q: Did treatment also reduce vasogenic white matter lesions on MRI?

No. The number of vasogenic cerebral white matter lesions on FLAIR increased significantly during follow-up.

Sep 30, 2026

Upload by kopisore

Antineutrophil cytoplasmic antibody-associated systemic vasculitis (AAV) most often affects the kidneys and may involve peripheral and central nervous systems, yet central manifestations are less considered, and the impact of treatment on cerebral vascular changes remains unclear. This study assessed treatment effects in 29 patients with AAV relapse presenting renal involvement, comparing baseline and follow-up at 12.6 ± 2.5 months using clinical, neurological, renal evaluations and brain MRI.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Article Analysis of Treatment Influence on Kidney Function and Brain Non-Contrast MRI Vascular Manifestations of Systemic ANCA-Associated Vasculitis with Renal Involvement Arkadiusz Lubas 1, *, Jacek Staszewski 2, Ksymena Le´sniak 1, Grzegorz Spłocharski 1, Arkadiusz Zegadło 3, Artur Maliborski 3, Aleksander D˛ebiec 2, Julia Bryłowska 4, Tymoteusz Lubas 5 and Stanisław Niemczyk 1 1 Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland; [sniemczyk@wim.mil.pl](sniemczyk@wim.mil.pl) (S.N.) 2 Department of Neurology, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland 3 Department of Radiology, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, Poland 4 Faculty of Medicine, University of Warsaw, 02-089 Warsaw, Poland; [j.brylowska@student.uw.edu.pl](j.brylowska@student.uw.edu.pl) [5](5 Faculty of Medicine)[ Faculty of Medicine](5 Faculty of Medicine), [Medical University of Gda](Medical University of Gda)[nsk](nsk)´ , [80-210 Gda](80-210 Gda)[nsk](nsk)´ , [Poland](Poland) * Correspondence: [alubas@wim.mil.pl](alubas@wim.mil.pl) Abstract Background: Antineutrophil cytoplasmic antibody-associated systemic vasculitis (AAV) most often involves the kidneys, upper airways and lungs, and peripheral and central nervous systems (PNS, CNS) . However, in contrast to PNS, the involvement of the CNS is rarely taken into account in the recognition and assessment of systemic vasculitis, probably because of nonspecific symptoms such as headaches and dizziness, aphasia, memory disorders, or mood changes. In addition, it is not clear whether treatment of systemic vasculitides reduces cerebral vascular alterations. In this study, we aimed to evaluate the effects of AAV treatment on vascular and vasogenic alterations in the brain in patients with acute vasculitis onset with renal involvement. Methods: Twenty-nine patients (17F, 12M, age 60.4 ± 9.8) with AAV relapse with renal involvement were included in the study. The initial baseline assessment and the second evaluation, performed 12.6 ± 2.5 months after the beginning of immunosuppressive treatment, included clinical, neurological, and renal function assessments, along with a brain MRI. Results: Compared with baseline, improvement in clinical, neurological, and renal function was observed during the second clinical evaluation. A significant reduction in the occurrence of vascular dilatation and narrowing in secondary (37.9% vs. 17.2%; p = 0.031) and tertiary (37.9% vs. 10.3%; p = 0.008) cerebral vascular branches was observed. However, the number of vasogenic cerebral white matter lesions detected on the FLAIR sequence increased significantly (36.0 vs. 48.0%; p < 0.001) . Conclusions: Intensive immunosuppressive treatment of acute-onset systemic AAV with renal involvement decreases disease activity, improves kidney function, and decreases central nervous system vascular but not vasogenic alterations. Academic Editor: Alba Scerrati Received: 24 November 2025 Revised: 10 December 2025 Accepted: 19 December 2025 Published: 21 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. Keywords: cerebral vasculitis; antineutrophil cytoplasmic antibodies; white matter lesions; immunosuppression 1. Introduction Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a heterogeneous group of rare autoimmune systemic diseases characterized by necrotizing inflammation of small-and medium-sized blood vessels. Three conditions that fall under the definition of AAV are microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis (EGPA). MPA, driven mainly by myeloperoxidase antibodies (p-ANCA), is

FAQs

What clinical and imaging outcomes were evaluated after AAV treatment?

The study assessed clinical, neurological, and renal function changes and performed brain MRI to quantify vascular and vasogenic alterations over follow-up.

How did treatment affect cerebral vascular alterations in patients?

Compared with baseline, treatment was associated with a significant reduction in the occurrence of vascular dilatation and narrowing in secondary and tertiary cerebral vascular branches.

Did treatment also reduce vasogenic white matter lesions on MRI?

No. The number of vasogenic cerebral white matter lesions on FLAIR increased significantly during follow-up.

Sep 30, 2026

Upload by kopisore