ANCA-associated vasculitis: diagnosis and treatment in the elderly

Parry, R. G.; Fletcher, Valerie; Medcalf, Pippa

doi:10.1136/pgmj.72.849.423

Cited by 9 publications

(8 citation statements)

References 13 publications

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“…Actually, three of four elderly patients with a poor outcome could not use immunosuppressive agents because of severe clinical conditions that were difficult to add further immunosuppression (massive alveolar hemorrhage) or infection. It is reported that possible reasons for not using additional immunosuppressive agents might be: (i) elderly patients often suffer severe vasculitis and show complications with several other diseases (diabetes, hypertension, renal failure); (ii) elderly patients have a reduced immune response because of impaired cell‐mediated immunity and a reduction in humoral immunity and (iii) elderly patients are more susceptible to adverse events associated with corticosteroids and CYP, such as diabetes, pancytopenia and, more importantly, infection . In our department, we did not use CYP for elderly AAV patients (aged >75 years) to avoid possible severe adverse events and infections as aforementioned.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes in patients with elderly‐onset anti‐neutrophil cytoplasmic antibody‐associated vasculitis

Sato

Yashiro

Matsuoka

et al. 2018

Geriatrics Gerontology Int

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Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes in patients with elderly‐onset anti‐neutrophil cytoplasmic antibody‐associated vasculitis

Sato

Yashiro

Matsuoka

et al. 2018

Geriatrics Gerontology Int

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“…As already reported in old people [2,[4][5][6][7], steroid and immunosuppressive treatments were effective in VS manifestations, but these treatments did not seem to influence the overall poor prognosis. The chosen therapy was adapted to each patient's status and was not directly the cause of death.…”

Section: Discussionmentioning

confidence: 53%

“…In view of our present experience, the usefulness of ANCA has been proved to be of help in the diagnosis of patients with an atypical presentation of VS [6,7]. Moreover, the prevalence of ANCA is low in healthy elderly people, less than 2.2% [11].…”

Section: Discussionmentioning

confidence: 99%

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Vasculitis in the Very Elderly

Turcu

Bielefeld²,

Besancenot³

et al. 2002

Gerontology

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Background: Whatever may be their clinical presentation, vasculitis syndromes (VS) have a bad prognosis in the very elderly. Objective: The aim of this work was to study VS particularities in very old people. Most published studies on VS in elderly people concern patients older than 60 years; studies concerning very old patients are unusual. Methods: We studied retrospectively subjects older than 75 years with a diagnosis of VS from the Departments of Geriatrics and Internal Medicine at Dijon University Hospital. These subjects were hospitalized between January 1995 and December 1999. Data were obtained from the medical files of these patients. Several aspects were considered: type of VS, associated diseases, treatment, complications, and outcome. Results: Twelve patients, 5 men and 7 women aged 79–91 (mean age 82.3) years, were included. Primary VS was observed in half of the patients and secondary VS in the others. The initial clinical presentation was often polymorphous and unspecific; 8 of the patients died, 2 developed progressive severe functional impairment, 1 was stabilized under therapy, and 1 patient with VS secondary to infection recovered. Most patients either died quickly or progressively deteriorated from infections, malnutrition, or functional impairment. Conclusion: The health of the majority of patients (83%) deteriorated dramatically, leading to death or severe functional impairment.

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“…At 18 months, no significant difference between the two groups was observed: azathioprine (15.5%) and oral cyclophosphamide (13.7%). Adverse events were similar in both groups [104,105].…”

Section: Azathioprinementioning

confidence: 70%

Vasculitides Throughout History and Their Clinical Treatment Today

Gamarra¹,

Peñaranda²,

Espinoza³

2011

Curr Rheumatol Rep

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Therapeutic management of the vasculitides is closely linked to modern rheumatologic advances, particularly as it relates to the discovery and first clinical use of glucocorticoids. These compounds were introduced in the late-1940s for the treatment of rheumatoid arthritis, but soon after, clinicians in Europe and the United States realized that they could have a significant positive impact in systemic vasculitides. However, once it was realized that glucocorticoid use was associated with a high degree of morbidity, the search for better immunosuppressive agents with similar efficacy but improved safety profiles was on. During the past several years, several agents have been utilized for the therapeutic management of systemic vasculitides, and the list keeps growing with the development of newer compounds that have retained efficacy but with a better safety profile.

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ANCA-associated vasculitis: diagnosis and treatment in the elderly

Abstract: SummaryWe report the successful treatment of three patients with ANCA-associated vasculitis aged 79, 80, and 80 years. We also review other published reports of treatment in the elderly and discuss complications of treatment with emphasis on elderly patients.

Cited by 9 publications

References 13 publications

Clinical features and outcomes in patients with elderly‐onset anti‐neutrophil cytoplasmic antibody‐associated vasculitis

Clinical features and outcomes in patients with elderly‐onset anti‐neutrophil cytoplasmic antibody‐associated vasculitis

Vasculitis in the Very Elderly

Vasculitides Throughout History and Their Clinical Treatment Today

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