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PURULENT-NECROTIC COMPLICATIONS OF THE MAXILLOFACIAL REGION IN ANCA-ASSOCIATED SYSTEMIC VASCULITIS: CLINICAL, IMMUNOMORPHOLOGICAL CHARACTERISTICS AND A DIFFERENTIATED TREATMENT ALGORITHM

Shukhrat BoymuradovTashkent State Medical University, Tashkent, UzbekistanKomiljon O. IminovTashkent State Medical University, Tashkent, UzbekistanShokhrukh Sh. YusupovTashkent State Medical University, Tashkent, UzbekistanYoqub Kh. KurbanovTashkent State Medical University, Tashkent, Uzbekistan 0000-0003-0343-7171 Email: [email protected] 5Tashkent State Medical University, Tashkent, UzbekistanErkin R. SarboyevTashkent State Medical University, Tashkent, UzbekistanAchilova Nodira GanievnaTashkent State Medical University, Tashkent, UzbekistanDavron E. KhayitmurodovTashkent State Medical University, Tashkent, UzbekistanBakhodir B. NajmiddinovTashkent State Medical University, Tashkent, Uzbekistan

2026en

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Litsenziya: cc-by

ABI

Annotatsiya

Background: Oral and maxillofacial lesions may be the presenting manifestation of ANCA-associated vasculitis (AAV), yet data comparing their clinical, serological and morphological profile across disease phenotypes, and the outcomes of structured treatment, are scarce. Methods: In this hospital-based observational cohort (2023–2026), 104 patients with AAV and purulent-necrotic maxillofacial lesions (GPA n = 46, MPA n = 32, EGPA n = 26) were assessed clinically, serologically (ANCA, IL-6, TNF-α), morphologically (histology, immunohistochemistry) and by MSCT; 20 healthy individuals served as a reference group. Patients were stratified by lesion severity (mild n = 42, moderate n = 32, severe n = 30) and treated with necrectomy, rituximab-based immunosuppression and microcirculation-targeted therapy, with local platelet-rich plasma added in moderate and severe disease and a rheological agent in severe disease. Follow-up was 12 months. Because enrolment required a maxillofacial lesion, the study describes the profile of lesion-positive patients and does not estimate lesion frequency in AAV; comparisons are descriptive. Results: GPA was characterised by PR3-ANCA (82.6%), granulomatous inflammation (78.3%) and CD68+ macrophage infiltration (80.4%); MPA by MPO-ANCA (75.0%); EGPA by eosinophilic infiltration (80.8%), elevated IgE (80.8%) and a more chronic course. Complete epithelialisation at short-term control was documented in 73.8%, 62.5% and 56.7% of the mild, moderate and severe groups, with IL-6 and TNF-α reductions of 52.6–60.0%. At 12 months, complete remission was seen in 65.4% and recurrence in 11.5%; recurrence did not differ significantly between phenotypes (p = 0.567). Conclusions: Among patients with established maxillofacial lesions, AAV phenotypes differ in clinical, serological and morphological profile. Treatment outcomes, obtained without a control group, require confirmation in prospective, multicentre studies of unselected AAV cohorts.

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DOI: 10.62441/actainnovations.vi.2466

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