OBJECTIVE: To determine the prevalence of severe infection and associated factors in patients diagnosed with ANCA-associated vasculitis (AAV) and Polyarteritis Nodosa (PAN).
METHODS: retrospective study was conduced in a single rheumatology center (2000-2018). We included patients diagnosed with AAV (Granulomatosis with Polyangiitis (GPA), Eosinophilic Granulomatosis with Polyangiitis (EGPA) and Microscopic Polyangiitis (PAM) and Polyarteritis nodosa (PAN). Serious infectious events requiring hospitalisation or prolonged antibiotic/antiviral treatment, recurrent infection of Herpes Zoster Virus or opportunistic infections were evaluated. Sites of infection, isolated microorganisms and mortality related were analyzed.
RESULTS: 105 patients were analyzed, follow-up time median 18 m, 58.7% were women and median age was 52 years. Types of vasculitis: 41.9% PAM, 16.2% EPGA, 40% GPA, 1.9% PAN. Constitutional, pulmonary, renal and otorhinolaryngology manifestations were the most frequent.
UNASSIGNED: 34.2%, with a median of 3 months from diagnosis of vasculitis to the infectious event. Low respiratory tract (42.8%), sepsis (31.4%), and urinary tract (14.3%) were the most common sites of infections. Bacterial aetiology was the most prevalent (67.7%). Mortality at the first event was 14.3% and a 72.2% of patients were in the induction phase of treatment. Infectious events were significantly associated with age > 65 years (p = 0.030), presence of lung (p = 0.016) and renal involvement (p = 0.001), BVASv3 > 15, mortality (p = 0.0002).
CONCLUSIONS: The prevalence of infection was 34.2%. Lower airway infections, septicemia and urinary tract infections were the most prevalent. Infections were associated with renal and pulmonary involvement, age older than 65 years and score BVAS > 15. Severe infections were associated with mortality, especially in elderly patients.
目的:确定诊断为ANCA相关性血管炎(AAV)和结节性多动脉炎(PAN)的患者中严重感染的患病率及相关因素。
方法:回顾性研究在一家风湿病中心(2000-2018年)进行。我们纳入了诊断为AAV(肉芽肿性多血管炎(GPA),嗜酸性肉芽肿性多血管炎(EGPA)和显微镜多血管炎(PAM)和结节性多动脉炎(PAN)。需要住院治疗或延长抗生素/抗病毒治疗的严重感染事件,对带状疱疹病毒反复感染或机会性感染进行了评估.感染部位,分离的微生物和死亡率进行了分析。
结果:分析了105例患者,随访时间中位数18米,58.7%为女性,中位年龄为52岁。血管炎的类型:41.9%PAM,16.2%EPGA,40%GPA,1.9%PAN。宪法,肺,肾脏和耳鼻咽喉科表现最常见。
■34.2%,从血管炎诊断到感染事件的中位数为3个月。低呼吸道(42.8%),脓毒症(31.4%),尿路(14.3%)是最常见的感染部位。细菌病因最普遍(67.7%)。第一个事件的死亡率为14.3%,72.2%的患者处于治疗的诱导期。感染事件与年龄>65岁显著相关(p=0.030),存在肺(p=0.016)和肾脏受累(p=0.001),BVASv3>15,死亡率(p=0.0002)。
结论:感染患病率为34.2%。下气道感染,败血症和尿路感染最普遍。感染与肾脏和肺部受累有关,年龄大于65岁,BVAS评分>15。严重感染与死亡率相关,尤其是老年患者。