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Prevalence and Risk Factors for Major Infections in Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis: Influence on the Disease Outcome.
Garcia-Vives, Eloi; Segarra-Medrano, Alfons; Martinez-Valle, Ferran; Agraz, Irene; Solans-Laque, Roser.
Afiliação
  • Garcia-Vives E; From the Autoimmune Systemic Diseases Unit, Internal Medicine Department, and Nephrology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
  • Segarra-Medrano A; E. Garcia-Vives, MD, Autoimmune Systemic Diseases Unit, Internal Medicine Department, Vall d'Hebron University Hospital; A. Segarra-Medrano, PhD, Nephrology Department, Vall d'Hebron University Hospital; F. Martinez-Valle, PhD, Autoimmune Systemic Diseases Unit, Internal Medicine Department, Vall d'
  • Martinez-Valle F; From the Autoimmune Systemic Diseases Unit, Internal Medicine Department, and Nephrology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
  • Agraz I; E. Garcia-Vives, MD, Autoimmune Systemic Diseases Unit, Internal Medicine Department, Vall d'Hebron University Hospital; A. Segarra-Medrano, PhD, Nephrology Department, Vall d'Hebron University Hospital; F. Martinez-Valle, PhD, Autoimmune Systemic Diseases Unit, Internal Medicine Department, Vall d'
  • Solans-Laque R; From the Autoimmune Systemic Diseases Unit, Internal Medicine Department, and Nephrology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
J Rheumatol ; 47(3): 407-414, 2020 03.
Article em En | MEDLINE | ID: mdl-31203229
OBJECTIVE: To analyze the role that infections play on the antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) outcome. METHODS: A retrospective study of adult patients with AAV diagnosed in a tertiary center. Clinical features, laboratory findings, treatment, relapses, major infections, and outcome were evaluated. RESULTS: Included were 132 patients [51 microscopic polyangiitis (MPA), 52 granulomatosis with polyangiitis (GPA), 29 eosinophilic GPA (EGPA)] with a mean followup of 140 (96-228) months. ANCA were positive in 85% of cases. A total of 300 major infections, mainly bacterial (85%), occurred in 60% patients during the followup. Lower respiratory tract (64%) and urinary tract infections (11%) were the most frequent, followed by bacteremia (10%). A total of 7.3% opportunistic infections were observed, most due to systemic mycosis. Up to 46% of all opportunistic infections took place in the first year of diagnosis, and 55% of them under cyclophosphamide (CYC) treatment. Bacterial infections were associated with Birmingham Vasculitis Activity Score (version 3) > 15 at the disease onset, a total cumulative CYC dose > 8.65 g, dialysis, and development of leukopenia during the followup. Leukopenia was the only factor independently related to opportunistic infections. Forty-four patients died, half from infection. Patients who had major infections had an increased mortality from any cause. CONCLUSION: Our results confirm that major infections are the main cause of death in patients with AAV.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Parasitos / Doenças Parasitárias / Bactérias / Infecções Bacterianas / Vírus / Infecções Oportunistas / Viroses / Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos / Fungos / Micoses Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Parasitos / Doenças Parasitárias / Bactérias / Infecções Bacterianas / Vírus / Infecções Oportunistas / Viroses / Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos / Fungos / Micoses Idioma: En Ano de publicação: 2020 Tipo de documento: Article