Document Detail


Clinical outcome and prognosis of anti-neutrophil cytoplasmic antibody-associated vasculitis in Japan.
MedLine Citation:
PMID:  20173346     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: We conducted a broad survey of 99 patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis and investigated both prognosis and outcomes. METHODS: Clinical data evaluated were age, sex, patient survival, renal survival, serum albumin, serum creatinine, urinary protein, hematuria, C-reactive protein (CRP), ANCA titer, IgG and the Birmingham Vasculitis Activity Score (BVAS). RESULTS: The patient survival rate at 6 months after onset was 84.8%, and that at 2 years after onset was 82.0%. Most deaths were within 6 months of onset. Infection accounted for 9 deaths (60.0%). Infection together with pulmonary involvement of active vasculitis accounted for 2 deaths (13.3%). Organ-specific involvement of active vasculitis alone caused 3 deaths (20.0%). Others died of cardiac events. At 1 and 3 months after onset, BVAS (p < 0.0001, p = 0.002), albumin (p = 0.006, p = 0.0004) and CRP (p = 0.04, p = 0.0002) were also associated with patient death. CONCLUSION: To improve the prognosis of those with ANCA-associated vasculitis, the intensity of initial treatment should be aimed at disease severity. Employing BVAS improved the ability to evaluate therapeutic responses. Finally, prescription with sulfamethoxazole-trimethoprim during the induction therapy with immunosuppressive agents may be advised.
Authors:
Mitsuyo Itabashi; Takashi Takei; Yasuko Yabuki; Hitoe Suzuki; Minoru Ando; Mayuko Akamatsu; Mayuko Yamazaki; Michihiro Mitobe; Yoshihiko Watanabe; Takahiro Mochizuki; Kosaku Nitta
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-19
Journal Detail:
Title:  Nephron. Clinical practice     Volume:  115     ISSN:  1660-2110     ISO Abbreviation:  Nephron Clin Pract     Publication Date:  2010  
Date Detail:
Created Date:  2010-04-30     Completed Date:  2010-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101159763     Medline TA:  Nephron Clin Pract     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  c21-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan. m-itaba@fb-4.so-net.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use*
Adult
Aged
Aged, 80 and over
Anti-Inflammatory Agents / therapeutic use
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / mortality*,  therapy*
Female
Humans
Japan / epidemiology
Male
Middle Aged
Outcome Assessment (Health Care)
Prevalence
Prognosis
Risk Assessment / methods
Risk Factors
Survival Analysis
Survival Rate
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Anti-Inflammatory Agents

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