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Tytuł pozycji:

Impact of aging on phenotype and prognosis in IgA vasculitis.

Tytuł:
Impact of aging on phenotype and prognosis in IgA vasculitis.
Autorzy:
Audemard-Verger A; Department of Internal Medicine and Clinical Immunology, CHRU Tours.; University of Tours, Tours.
Pillebout E; Department of Nephrology, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes, Paris.
Baldolli A; Department of Infectious Diseases, CHU de Caen, Caen.
Gouellec NL; Department of Internal Medicine and Nephrology, CH de Valenciennes, Valenciennes.
Augusto JF; Department of Nephrology, CHU d'Angers, Angers.
Jourde-Chiche N; Department of Nephrology, AP-HM, Aix-Marseille Université, C2VN, INSERM, INRAE, Marseille.
Raffray L; Department of Internal Medicine, CHU de la Réunion, La Réunion.; Université de La Réunion, UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), INSERM 1187, CNRS 9192, IRD 249, La Réunion.
Thervet E; Department of Nephrology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris.
Deroux A; Department of Internal Medicine, CHU de Grenoble, Grenoble.
Goutte J; Department of Internal Medicine, CHU de St Etienne, St Etienne.
Hummel A; Department of Nephrology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris.
Lioger B; Department of Internal Medicine, Hopital de Blois, Blois.
Sanges S; Département de Médecine Interne et Immunologie Clinique, CHU Lille, Lille.
Cacoub P; Department of Internal Medicine and Clinical Immunology, Hôpital Pitié-Salpétrière, AP-HP.; Inflammation-Immunopathology-Biotherapy Department (DHU i2B), UMR 7211, UPMC Université Paris 06, Sorbonne Universités.
Amoura Z; Department of Internal Medicine, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris.
Moulis G; Department of of Internal Medicine, CHU de Toulouse, Toulouse.; Clinical Investigation Center 1436, Toulouse University hospital, Toulouse.
Maurier F; Department of Internal Medicine, Hôpitaux privés, Met.
Lavigne C; Department of Internal Medicine, CHU d'Angers, Angers.
Urbanski G; Department of Internal Medicine, CHU d'Angers, Angers.
Chanal J; Department of Dermatology, Hôpital Tarnier, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris.
Faguer S; Department of Nephrology and Organ Transplantation, CHU de Toulouse, Toulouse.
Deriaz S; Department of Internal Medicine and Clinical Immunology, CHRU Tours.
Feirreira-Maldent N; Department of Internal Medicine and Clinical Immunology, CHRU Tours.
Diot E; Department of Internal Medicine and Clinical Immunology, CHRU Tours.
Maillot F; Department of Internal Medicine and Clinical Immunology, CHRU Tours.; University of Tours, Tours.
Guillevin L; Université Paris Descartes.; Department of Internal Medicine, Hôpital Cochin.; National Referral Center for Systemic and Autoimmune Diseases, Hôpital Cochin, Paris, France.
Terrier B; Université Paris Descartes.; Department of Internal Medicine, Hôpital Cochin.; National Referral Center for Systemic and Autoimmune Diseases, Hôpital Cochin, Paris, France.
Źródło:
Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2021 Sep 01; Vol. 60 (9), pp. 4245-4251.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Original Publication: Oxford, UK : Avenel, N.J. : Oxford University Press ; Distributed by Mercury International, c1999-
MeSH Terms:
Immunoglobulin A*
Aging/*immunology
Kidney Failure, Chronic/*etiology
Vasculitis/*diagnosis
Adult ; Age Factors ; Aged ; Female ; Humans ; Kidney Failure, Chronic/immunology ; Male ; Middle Aged ; Phenotype ; Prognosis ; Retrospective Studies ; Vasculitis/immunology
Contributed Indexing:
Keywords: Henoch–Schönlein purpura; IgA vasculitis; age; outcome; prognosis; renal involvement
Substance Nomenclature:
0 (Immunoglobulin A)
Entry Date(s):
Date Created: 20210107 Date Completed: 20211004 Latest Revision: 20211004
Update Code:
20240105
DOI:
10.1093/rheumatology/keaa921
PMID:
33410479
Czasopismo naukowe
Objectives: Immunoglobulin A vasculitis (IgAV) is a small-vessel vasculitis most frequently benign in children while more severe in adults. We aimed to study the impact of age on presentation and outcome of adult IgAV.
Methods: We conducted a nationwide retrospective study including 260 IgAV patients. Patients were divided into four quartiles according to the age at IgAV diagnosis: <36, 36 ≤ age < 52; 52 ≤ age < 63 and ≥63 years. Comparison of presentation and outcome were performed according to age of disease onset.
Results: Mean age at diagnosis was 50.1 (18) years and 63% were male. IgAV diagnosed in the lowest quartile of age was associated with more frequent joint (P < 0.0001) and gastrointestinal involvement (P = 0.001). In contrast, the oldest patients had more severe purpura with necrotic lesions (P = 0.001) and more frequent renal involvement (P < 0.0001), with more frequent haematuria, renal failure, higher urine protein excretion and more frequent tubulointerstitial lesions. Patients were treated similarly in all groups of age, and clinical response and relapse rates were similar between groups. In the 127 treated patients with follow-up data for >6 months, clinical response and relapse rates were similar between the four groups. Median follow-up was of 17.2 months (9.1-38.3 months). Renal failure at the end of follow-up was significantly more frequent in the highest quartile of age (P = 0.02), but the occurrence of end-stage renal disease was similar in all groups. Last, overall and IgAV-related deaths were associated with increase in age.
Conclusion: Aging negatively impacts the severity and outcome of IgAV in adults. Younger patients have more frequent joint and gastrointestinal involvement, while old patients display more frequent severe purpura and glomerulonephritis.
(© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

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