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01-09-2021 | Vasculitis | Observational Research

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

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

Published in: Rheumatology International | Issue 9/2021

Abstract

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.

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Title: Interstitial lung disease with myeloperoxidase-antineutrophil cytoplasmic antibody-associated vasculitis in elderly patients
Authors: Koichi Yamaguchi
Aya Yamaguchi
Miki Itai
Yuji Onuki
Yuki Shin
Shogo Uno
Chiharu Hanazato
Kohei Taguchi
Kazue Umetsu
Masaki Aikawa
Shunichi Kouno
Masao Takemura
Kenichiro Hara
Shinsuke Motegi
Mayuko Tsukida
Fumie Ota
Yoshito Tsukada
Mitsuru Motegi
Masao Nakasatomi
Toru Sakairi
Hidekazu Ikeuchi
Yoriaki Kaneko
Keiju Hiromura
Toshitaka Maeno
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Vasculitis
Vasculitis
Prednisolone
Published in: Rheumatology International / Issue 9/2021
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-021-04891-7

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