Vasculitis & polymyalgia rheumatica
Predictors of early severe respiratory distress in ANCA-associated vasculitis with diffuse alveolar haemorrhage: a multicentre REVEAL cohort study
Authors' conclusion
This multicentre study highlights the peripheral neutrophil count as a simple and readily available biomarker for risk stratification in AAV-DAH.
Study context
- Population
- Consecutive patients with antibody-associated vasculitis (AAV)-related diffuse alveolar haemorrhage (DAH) in the multicentre REVEAL cohort
- Participants
- 50 patients
- Outcome
- Severe respiratory distress (SRD): respiratory failure requiring ventilatory support (high-flow oxygen, non-invasive or invasive mechanical ventilation) or DAH-related death
- Follow-up
- Within 30 days
Methodological detailsmulticentre, consecutive patients, Cox proportional hazards models
- Multicentre
- Consecutive patients
- Cox proportional hazards models
Main finding
As reported in the abstract
SRD (ventilatory support or DAH-related death within 30 days)
Severe respiratory distress (SRD) occurred
14 patients
28%
Neutrophil cut-off discriminating high- and low-risk patients
8,800/μL
Observational data: associations, not effects.
Further findings
Baseline characteristics of patients with SRD
- Significantly higher neutrophil counts, lower haemoglobin, higher CRP and impaired oxygenation (lower PaO2/FiO2 ratio) in patients who developed SRD
Independent predictor of SRD (multivariate analysis)
- Neutrophil count cut-off discriminating high- and low-risk patients
- 8,800/μL
- Peripheral neutrophil count was an independent predictor of SRD
- Neutrophilia associated with early progression to SRD
Original publication
Predictors of early severe respiratory distress in ANCA-associated vasculitis with diffuse alveolar haemorrhage: a multicentre REVEAL cohort study. Clin Exp Rheumatol. Published 6 April 2026. doi:10.
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