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Open research questions in Vasculitis and related conditions

34 unresolved questions extracted from the limitations and future-work sections of 255 Vasculitis and related conditions papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Background Drug-induced bone marrow injury is an under-recognised adverse drug reaction (ADR) that can present with fever, cytopenias, and eosinophilia.

    Case Report: Qizhi Yishen Capsule-induced bone marrow granulomas and severe myelosuppression · 2026 · DOI

  • This case illustrates the value of ANCA serology and multisystem pattern recognition in securing a diagnosis of GPA even when histopathology is non-diagnostic, and highlights cranial mononeuropathy as an under-recognised, potentially irreversible manifestation of the disease.

    AN INTERESTING CASE OF GRANULOMATOSIS WITH POLYANGIITIS (WEGENER'S GRANULOMATOSIS) MASQUERADING AS A MULTISYSTEM DISORDER · 2026 · DOI

  • Although MVI is becoming more accessible, it may prove difficult to compare results between different ultrasound units and users, given equipment variability, lack of standardized protocols (approach, views, settings), and operator experience (17). Given this case report and the increased scientific evi- dence in human medicine, these imaging modalities have the potential to assist in the diagnosis, treatment selection, assessment of response to therapy, and prognosis for various inflammatory arthropathies in dogs, warranting further research.

    Ultrasound microvascular flow imaging and photon counting computed tomography support the diagnosis and assist in treatment monitoring of canine erosive immune mediated polyarthropathy: a case report · 2026 · DOI

  • Although the association between SMZL and the coexistence of MPA and SLE in this case remains unclear, careful follow-up considering the potential coexistence of autoimmune diseases such as MPA and SLE in patients with SMZL may be warranted.

    Coexistence of Microscopic Polyangiitis, Systemic Lupus Erythematosus, and Transthyretin Amyloidosis in an Elderly Japanese Patient With Splenic Marginal Zone Lymphoma: An Autopsy Case Report · 2026 · DOI

  • Vascular FDG uptake was observed in over a third of patients in our cohort, supporting the diagnostic value of PET/CT in evaluating suspected vasculitis. They align with previously published data [7, 11]. Inter-observer agreement for vascular involvement was low and not significant (κ = 0.216). Upon reviewing discordant cases, FDG uptake intensity appeared to be an unreliable criterion. Comparison with liver SUVmax, as used in GCA [16], is not applicable to smaller vessels due to their inherently low uptake. The extent of vascular uptake, particularly the unusual visibility of distal vessel branches, seems to be a more reliable indi- cator. This “tree-root-like” appearance has been previously described in various types of vasculitis, including ANCA- associated vasculitis [17]. These results underscore the need for standardized [18F]FDG PET/CT interpretation criteria for medium-sized vessel vasculitis. Osteomedullary hypermetabolism was the most frequent metabolic finding, as previously reported [7]. In most cases, it was related to reactive bone marrow, due to systemic inflammation, as suggested by higher CRP levels in these patients. In some cases, this osteomedullary hypermetabo- lism extended to long bones. These patients often presented with underlying hematologic disorders, such as myeloid malignancies. Therefore, our findings suggest that [18F] FDG PET/CT may be useful in detecting secondary forms of PAN related to hematological malignancies. Although PET/CT has lower sensitivity than dental CT, some focal dental uptakes of infectious origin were detected. These findings are important to note, as PAN may be triggered by infection and can fully recover following adequate dental The first limitation of this study is its retrospective design. However, given the low incidence of PAN, a prospective approach is difficult to achieve for this type of investiga- tion. Second, only patients who underwent [ 18 F]FDG PET/ CT were included. Therefore, we cannot exclude a potential selection bias toward a specific PAN profile, possibly more atypical and/or severe. Although the overall distribution of organ involvement in our cohort is broadly consistent with that reported in other large PAN series [2, 18], some differ- ences were observed (e.g. older patients, higher prevalence of myocarditis, and lower prevalence of mononeuritis mul- tiplex). Finally, [18F]FDG PET/CT examinations were per- formed over a wide time period. Consequently, we cannot exclude that the interpretation of some parameters may have been influenced by scanner generation. Nevertheless, except for the ant-farm sign and vascular uptake (which were more frequently observed on digital PET/CT systems), the assess- ment of most other organ involvements is unlikely to have been substantially affected by PET/CT system generation.

    [18F]FDG PET/CT value in the diagnostic evaluation of patients with polyarteritis nodosa · 2026 · DOI

  • The paper highlights that older patients often present with nonspecific symptoms and reduced physiological reserve, delaying diagnosis, but there is insufficient evidence on early diagnostic strategies or screening protocols specifically designed for geriatric AAV presentation.

    Microscopic Polyangiitis in a Nonagenarian: Diagnostic and Therapeutic Challenges in Geriatric Vasculitis · 2026 · DOI

  • While psychosocial factors such as self-perceived health, optimistic outlook, and strong social supports are noted as protective factors for improved outcomes in older adults with AAV, prospective studies quantifying their impact on treatment response and long-term prognosis are limited.

    Microscopic Polyangiitis in a Nonagenarian: Diagnostic and Therapeutic Challenges in Geriatric Vasculitis · 2026 · DOI

  • Limited evidence exists regarding the optimal management of concurrent thrombotic complications (such as DVT) in elderly patients with active AAV requiring immunosuppressive therapy and anticoagulation.

    Microscopic Polyangiitis in a Nonagenarian: Diagnostic and Therapeutic Challenges in Geriatric Vasculitis · 2026 · DOI

  • The paper emphasizes that chronologic age alone is a poor predictor of treatment tolerance and that physiologic age, functional capacity, and cognitive resilience are better predictors, but more prospective studies comparing chronologic versus physiologic age-based treatment strategies in geriatric AAV are needed.

    Microscopic Polyangiitis in a Nonagenarian: Diagnostic and Therapeutic Challenges in Geriatric Vasculitis · 2026 · DOI

  • While the Clinical Frailty Scale is recognized as a validated tool to quantify physiologic reserve and guide treatment decisions in elderly AAV patients, further prospective validation of the CFS as a predictor of treatment tolerance and outcomes in this specific population is needed.

    Microscopic Polyangiitis in a Nonagenarian: Diagnostic and Therapeutic Challenges in Geriatric Vasculitis · 2026 · DOI

  • The paper notes that prospective studies have documented substantial 12-month complication rates from high-dose glucocorticoids in seniors, but there is insufficient evidence on optimal glucocorticoid dosing and tapering schedules specifically tailored for elderly AAV patients.

    Microscopic Polyangiitis in a Nonagenarian: Diagnostic and Therapeutic Challenges in Geriatric Vasculitis · 2026 · DOI

  • While the RAVE trial demonstrated rituximab non-inferiority to cyclophosphamide for induction in patients with renal involvement, prospective comparative studies specifically examining outcomes in geriatric AAV populations are lacking.

    Microscopic Polyangiitis in a Nonagenarian: Diagnostic and Therapeutic Challenges in Geriatric Vasculitis · 2026 · DOI

  • Although a numerical trend was observed whereby infection-related mortality was higher in the high NLR group, the lack of statistical significance may be attributed to the limited number of fatal events; thus, larger cohort studies are warranted to further elucidate the association between NLR and specific causes of death.

    The neutrophil-to-lymphocyte ratio is associated with adverse outcomes in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis · 2026 · DOI

  • Future prospective studies with extended follow-up periods and comprehensive inclusion of established clinicopathological predictors are warranted to further clarify the relationship between NLR and long-term renal prognosis.

    The neutrophil-to-lymphocyte ratio is associated with adverse outcomes in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis · 2026 · DOI

  • The etiology of HSP remains unknown, although infections (mainly upper respiratory tract infections), drugs, food, insect bites, and vaccinations may trigger HSP.

    Zinc Levels and Laboratory Indices in Children With Henoch-Schönlein Purpura · 2021 · DOI

  • The relationship between HCV-associated ANCA with anti-PR3 specificity and prevalence of stroke outcomes requires more comprehensive characterization.

    Association of anti-neutrophil cytoplasmic antibody in ischemic stroke Egyptian patients with hepatitis C virus · 2021 · DOI

  • The mechanism by which autoimmune manifestations in chronic HCV infection occur through cross reactive immune reactions between viral epitopes and human proteins has been identified, but the specific role of ANCA in this process and its contribution to ischemic stroke risk remains incompletely understood.

    Association of anti-neutrophil cytoplasmic antibody in ischemic stroke Egyptian patients with hepatitis C virus · 2021 · DOI

  • While some extrahepatic manifestations of HCV have clear associations with infection, others are induced by immune responses triggered by HCV infection, but the specific mechanisms distinguishing these two pathways require further clarification.

    Association of anti-neutrophil cytoplasmic antibody in ischemic stroke Egyptian patients with hepatitis C virus · 2021 · DOI

  • The origin of the ANCA autoimmune response is still under examination as there are many mechanisms responsible for the development of AAV which are still not fully understood.

    Patogeneza zapaleń naczyń związanych z przeciwciałami przeciwko cytoplazmie neutrofilów · 2018 · DOI

  • Although the causal relationship remains incompletely understood, the occurrence of vasculitis in close temporal proximity to cancer diagnosis and its improvement following oncologic treatment are considered suggestive of a paraneoplastic origin.

    Paraneoplastic Myeloperoxidase (MPO)-Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis Revealing Colon Adenocarcinoma in a Patient With Controlled HIV Infection: A Case Report · 2026 · DOI

  • The Cox regression models did not account for treatment-related immunosuppressive regimens, glucocorticoid exposure, renal histopathology, or longitudinal proteinuria, which may limit the interpretability of the findings.

    The neutrophil-to-lymphocyte ratio is associated with adverse outcomes in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis · 2026 · DOI

  • First contact doctors are often family doctors or dermatologists, along with the fact that the awareness of doctors of other specialties about this pathology is insufficient.

    Diagnostic and Treatment of Cryoglobulinemiс Vasculitis: What is Important for Real Clinical Practice? · 2019 · DOI

  • The aetiology of WG remains unknown although a number of exogenous factors have been suggested to be of aetiological relevance.

    <scp>W</scp>egener's granulomatosis: a review of clinical features and an update in diagnosis and treatment · 2013 · DOI

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34 open questions have been extracted from the limitations and future-work passages of 255 Vasculitis and related conditions papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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