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CC BY 4.0 · Int Arch Otorhinolaryngol 2024; 28(01): e83-e94
DOI: 10.1055/s-0043-1767803
Original Research

Clinical Manifestations of Wegener Granulomatosis in Iranian Ethnicities Using the K-Means Algorithm: A Descriptive Study

Fahimeh Khedmatkon 
1   Department of Academics, Tehran University of Medical Sciences, Tehran, The Islamic Republic of Iran
,
Samira Alesaeidi 
2   Department of Internal Medicine, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, the Islamic Republic of Iran
,
Fatemeh Hajialiasgari 
1   Department of Academics, Tehran University of Medical Sciences, Tehran, The Islamic Republic of Iran
,
Jaleh Shoshtarian Malak 
1   Department of Academics, Tehran University of Medical Sciences, Tehran, The Islamic Republic of Iran
› Author Affiliations Funding The author(s) received no financial support for the research.
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Abstract

Introduction Wegener granulomatosis (WG) appears with clinical symptoms, including recurrent respiratory infection, renal manifestations, and nonspecific systemic symptoms.

Objective To study the clinical manifestations of WG in Iranian ethnicities, and data on 164 patients were recorded from 2013 to 2018.

Methods The data included demographics, symptoms, and the Birmingham Vasculitis Activity Score (BVAS). The symptoms involved the following sites: the nose, sinus, glottis, ears, lungs, kidneys, eyes, central nervous system, mucous membranes, skin, heart, stomach, intestine, as well as general symptoms. The clinical manifestations of nine ethnicities were analyzed.

Results In total, 48% of the patients were male and 51% were female, with a median age of 51 years. The BVAS was of 15.4, the sites most involved were the sinus (n = 155), nose (n = 126), lungs (n = 125), and ears (n = 107). Gastrointestinal (n = 14) and cardiac (n = 7) involvement were less common. Among the patients, 48.17% were Persian, 13.41% were Azari, 11.17% were Gilaki, 11.17% were Kurd, and 10.9% were Lor.

Conclusion Our findings indicated that the sinus, nose, lungs, and ears were the sites most involved, and gastrointestinal and cardiac involvement were less common. In the present study, involvement of the upper and lower respiratory tract was higher than that reported in Western and Asian case series. Moreover, we report for the first time that, in all patients with ear involvement, the left ear was the first to be affected. The clinical manifestations among Iranian ethnicities were not different, and the Gilaki ethnicity had the highest BVAS, mostly because the weather was humid; therefore, in Iran, in areas with humidity, the rate of the disease was higher.

Keywords

Wegener granulomatosis - granulomatosis with polyangiitis - ethnicity - data mining - clustering


Publication History

Received: 03 July 2022

Accepted: 02 February 2023

Article published online:
05 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Jiménez Caballero PE, Segura Martín T. Cardioembolic stroke secondary to non-bacterial endocarditis in Wegener disease. Eur J Neurol 2007; 14 (06) 683-685
    CrossrefPubMedGoogle Scholar
  • 2 Costa CF, Polanski JF. Wegener Granulomatosis: Otologic Manifestation as First Symptom. Int Arch Otorhinolaryngol 2015; 19 (03) 266-268
    PubMedGoogle Scholar
  • 3 Watts RA, Lane S, Scott DG. What is known about the epidemiology of the vasculitides?. Best Pract Res Clin Rheumatol 2005; 19 (02) 191-207
    CrossrefPubMedGoogle Scholar
  • 4 Mahr A, Guillevin L, Poissonnet M, Aymé S. Prevalences of polyarteritis nodosa, microscopic polyangiitis, Wegener's granulomatosis, and Churg-Strauss syndrome in a French urban multiethnic population in 2000: a capture-recapture estimate. Arthritis Rheum 2004; 51 (01) 92-99
    CrossrefPubMedGoogle Scholar
  • 5 Sada KE, Amano K, Uehara R. et al; Research Committee on Intractable Vasculitides, the Ministry of Health, Labour, Welfare of Japan. A nationwide survey on the epidemiology and clinical features of eosinophilic granulomatosis with polyangiitis (Churg-Strauss) in Japan. Mod Rheumatol 2014; 24 (04) 640-644
    CrossrefPubMedGoogle Scholar
  • 6 Mahr AD, Neogi T, Merkel PA. Epidemiology of Wegener's granulomatosis: Lessons from descriptive studies and analyses of genetic and environmental risk determinants. Clin Exp Rheumatol 2006; 24 (2, Suppl 41) S82-S91
    PubMedGoogle Scholar
  • 7 Stone JH, Hoffman GS, Merkel PA. et al; International Network for the Study of the Systemic Vasculitides (INSSYS). A disease-specific activity index for Wegener's granulomatosis: modification of the Birmingham Vasculitis Activity Score. Arthritis Rheum 2001; 44 (04) 912-920
    CrossrefPubMedGoogle Scholar
  • 8 cia.gov. [Internet]. United States: Central Intelligence Agency. Available from: https://www.cia.gov/the-world-factbook/countries/iran/#transnational-issues.
    Google Scholar
  • 9 Elling RC, Harris K. Difference in difference: language, geography, and ethno-racial identity in contemporary Iran. Ethn Racial Stud 2021; 44 (12) 2255-2281
    CrossrefGoogle Scholar
  • 10 Sudirman, Windarto A, Wanto A. Data mining tools | RapidMiner: K-means method on clustering of rice crops by province as efforts to stabilize food crops in Indonesia. IOP Conf Series Mater Sci Eng 2018; 10 (420) 012089
    Google Scholar
  • 11 Zarepur E, Mohammadifard N, Mansourian M. et al. Rationale, design, and preliminary results of the Iran-premature coronary artery disease study (I-PAD): A multi-center case-control study of different Iranian ethnicities. ARYA Atheroscler 2020; 16 (06) 295-300
    PubMedGoogle Scholar
  • 12 Behura A. Intelligent Automotive Sector with IoT (Internet of Things) and its Consequential Impact in Vehicular Ad hoc Networks. Internet of Things and Its Applications. 2021; ; ( 427-449
    Google Scholar
  • 13 Sitompul BJD, Sitompul OS, Poltak S. Enhancement Clustering Evaluation Result of Davies-Bouldin Index with Determining Initial Centroid of K-Means Algorithm. J Phys Conf Ser 2019; 1235: 012015
    CrossrefGoogle Scholar
  • 14 Singh SR, Oak J, Olickal MS. Granulomatosis with polyangiitis: Experience of 42 patients from a single-center, tertiary care hospital in Mumbai. Indian J Rheumatol 2021; 16 (02) 145-151
    CrossrefGoogle Scholar
  • 15 Shobha V, Fathima S, Prakash R. Granulomatosis with polyangiitis: clinical course and outcome of 60 patients from a single center in South India. Clin Exp Med 2018; 18 (03) 347-353
    CrossrefPubMedGoogle Scholar
  • 16 Terrier B, Dechartres A, Deligny C. et al. Granulomatosis with polyangiitis according to geographic origin and ethnicity: clinical-biological presentation and outcome in a French population. Rheumatology (Oxford) 2017; 56 (03) 445-450
    PubMedGoogle Scholar