Interstitial lung disease with myeloperoxidase-antineutrophil cytoplasmic antibody-associated vasculitis in elderly patients

Yamaguchi, Kazutaka; Yamaguchi, Aya; Itai, Miki; Onuki, Yuji; Shin, Yuki; Uno, Shogo; Hanazato, Chiharu; Taguchi, Kohei; Umetsu, Kazue; Aikawa, Masaki; Kouno, Shunichi; Takemura, Masao; Hara, Kenichiro; Motegi, Shinsuke; Tsukida, Mayuko; Ota, Fumie; Tsukada, Yoshito; Motegi, Mitsuru; Nakasatomi, Masao; Sakairi, Toru; Ikeuchi, Hidekazu; Kaneko, Yoriaki; Hiromura, Keiju; Maeno, Toshitaka

doi:10.1007/s00296-021-04891-7

Cited by 6 publications

(3 citation statements)

References 35 publications

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“…A recent retrospective study of 76 patients found age at least 70 years and UIP pattern to be associated with high mortality [69 ▪ ]. Glucocorticoid pulse therapy was reported as a significant risk factor for severe infection in a cohort of elderly AAV-ILD patients [70]. BAL neutrophilia has also been identified as an independent predictor of mortality among AAV-ILD patients [9 ▪▪ ].…”

Section: Discussionmentioning

confidence: 99%

Interstitial lung disease in patients with anti-neutrophil cytoplasm antibody-associated vasculitis: an update on pathogenesis and treatment

Turgeon

Balter

Pagnoux

2023

Current Opinion in Pulmonary Medicine

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Purpose of review Interstitial lung disease (ILD) is now recognized as a common complication of anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV), especially myeloperoxidase (MPO)-ANCA-positive AAV and microscopic polyangiitis (MPA). This review focuses on current concepts pertaining to the pathogenesis, clinical assessment, and management of AAV-ILD. Recent findings ILD is typically identified before or at the onset of systemic AAV, and usual interstitial pneumonia (UIP) is the most common CT pattern. MPO-ANCA production, neutrophil extracellular traps formation, reactive oxidative species production, complement activation, environmental exposures, and genetic background might play a role in the pathogenesis of AAV-ILD. Recent research has identified promising biomarkers as potential diagnostic and prognostic tools in AAV-ILD. The optimal treatment for AAV-ILD is not well defined but might rely on a combination of immunosuppression and antifibrotics, especially in patients with progressive lung fibrosis. Despite the effectiveness of current therapies for AAV, the outcome of patients with AAV-ILD remains poor. Summary ANCA screening should be considered in patients with newly diagnosed ILD. Management of AAV-ILD should be overviewed by a collaborative team comprising vasculitis experts and respirologists. Graphical abstract http://links.lww.com/COPM/A33

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Section: Discussionmentioning

confidence: 99%

Interstitial lung disease in patients with anti-neutrophil cytoplasm antibody-associated vasculitis: an update on pathogenesis and treatment

Turgeon

Balter

Pagnoux

2023

Current Opinion in Pulmonary Medicine

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“…Notably, in 4 patients who had not previously undergone chest HRCT, pulmonary fibrosis was found during follow-up [ 39 ]. A comparison of the present study with previously published reports of MPO-ANCA ILD patients is summarized in Table 2 [ 17 , 19 , 20 , 34 , 35 , 38 , [40] , [41] , [42] , [43] , [44] , [45] , [46] ].…”

Section: Discussionmentioning

confidence: 76%

Presentation and progression of MPO-ANCA interstitial lung disease

Salvati,

Palterer,

Lazzeri

et al. 2024

Journal of Translational Autoimmunity

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“…In RA-ILD, prednisolone doses higher than 10 mg are associated with a higher risk of infectious comorbidity [69]. As also with MPA-ILD in elderly patients, the administration of high-dose corticosteroid therapy is a significant risk factor for severe infection, which is a main cause of death [70]. In general, corticosteroids had been considered to result in a higher risk of chronic pulmonary infection, such as nontuberculous mycobacteria and pulmonary aspergillosis [71,72].…”

Section: Mpo-anca-positive Ild Patients Without Systemic Vasculitis A...mentioning

confidence: 99%

Anti-Inflammatory and/or Anti-Fibrotic Treatment of MPO-ANCA-Positive Interstitial Lung Disease: A Short Review

Yamakawa

Toyoda

Baba

et al. 2022

JCM

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The presence of a lung lesion is common in microscopic polyangiitis (MPA), and interstitial lung disease (ILD) can lead to a poor prognosis. Although myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA) are often present in patients with MPA, patients with ILD and MPO-ANCA positivity but without other manifestations of systemic vasculitis have also been reported. Therefore, the possible association between MPO-ANCA, MPA, and idiopathic ILD remains unclear. This problematic matter has influenced the treatment strategy of MPO-ANCA-positive ILD patients without systemic vasculitis. Clinicians should undertake treatment with careful consideration of the four major causes of death in MPO-ANCA-positive ILD: acute exacerbation of ILD, progressive lung fibrosis, infectious comorbidities, and diffuse alveolar hemorrhage. Further, clinicians need to carefully judge whether inflammation or fibrosis is the dominant condition with reference to the patient’s clinical domain and radiopathological lung features. Recently, anti-fibrotic agents such as nintedanib and pirfenidone were shown to be effective in treating various etiologies associated with ILD and have thus led to the widening of treatment options. In this review, the clinical characteristics, radiopathology, prognosis, and therapeutic options in patients with MPO-ANCA-positive ILD are summarized using limited information from previous studies.

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Interstitial lung disease with myeloperoxidase-antineutrophil cytoplasmic antibody-associated vasculitis in elderly patients

Cited by 6 publications

References 35 publications

Interstitial lung disease in patients with anti-neutrophil cytoplasm antibody-associated vasculitis: an update on pathogenesis and treatment

Interstitial lung disease in patients with anti-neutrophil cytoplasm antibody-associated vasculitis: an update on pathogenesis and treatment

Presentation and progression of MPO-ANCA interstitial lung disease

Anti-Inflammatory and/or Anti-Fibrotic Treatment of MPO-ANCA-Positive Interstitial Lung Disease: A Short Review

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