Interstitial lung disease with myeloperoxidase-antineutrophil cytoplasmic antibody-associated vasculitis in elderly patients.
Koichi YamaguchiAya YamaguchiMiki ItaiYuji OnukiYuki ShinShogo UnoChiharu HanazatoKohei TaguchiKazue UmetsuMasaki AikawaShunichi KounoMasao TakemuraKenichiro HaraShinsuke MotegiMayuko TsukidaFumie OtaYoshito TsukadaMitsuru MotegiMasao NakasatomiToru SakairiHidekazu IkeuchiYoriaki KanekoKeiju HiromuraToshitaka MaenoPublished in: Rheumatology international (2021)
Anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV) occurs in elderly people, and patients with anti-myeloperoxidase autoantibodies (MPO-ANCA)-positive AAV are often complicated with interstitial lung disease (ILD). This study aimed to evaluate the age-related clinical features of elderly patients with MPO-ANCA-positive AAV-ILD. This study retrospectively investigated 63 patients with MPO-ANCA-positive AAV-ILD, all of whom were 65 years or older at diagnosis. Clinical characteristics, causes of death and survival rates among three groups stratified by age (65-74 years, n = 29; 75-79 years, n = 18; over 80 years, n = 16) were compared. This study also examined the association with severe infections in these patients. Among the three age groups, there were significant differences in sex (P = 0.032), serum Krebs von den Lungen-6 (P < 0.01), and total ground-glass opacity score (P = 0.011). The causes of death were mainly severe infections and complications of ILD. Kaplan-Meier curve analysis showed a significantly lower 5-year survival rate in the oldest group (P < 0.01). Regarding severe infections in these patients, the 5-year cumulative incidence of severe infections was higher in the patients receiving steroid pulse therapy (P = 0.034). The clinical characteristics of MPO-ANCA-positive AAV-ILD differ with age in elderly patients, with age being an important poor prognostic factor in these patients. The administration of steroid pulse therapy is a significant risk factor of severe infection in MPO-ANCA-positive elderly patients with AAV-ILD.
Keyphrases
- interstitial lung disease
- systemic sclerosis
- prognostic factors
- end stage renal disease
- rheumatoid arthritis
- idiopathic pulmonary fibrosis
- newly diagnosed
- ejection fraction
- chronic kidney disease
- early onset
- risk factors
- gene therapy
- systemic lupus erythematosus
- blood pressure
- peritoneal dialysis
- middle aged
- community dwelling
- physical activity
- mesenchymal stem cells
- mass spectrometry
- bone marrow
- high resolution
- replacement therapy