Lymphopenia and Treatment-Related Infectious Complications in ANCA-Associated Vasculitis
Open Access
- 1 March 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Journal of the American Society of Nephrology
- Vol. 8 (3), 416-423
- https://doi.org/10.2215/cjn.07300712
Abstract
Background and objectives ANCA-associated vasculitis (AAV) is treated with potent immunosuppressive regimens. This study sought to determine risk factors associated with infections during first-intention therapy. Design, setting, participants, & measurements This retrospective study involved two separate cohorts of consecutive cases of AAV seen from 2004 to 2011 at two university hospitals. The following were assessed: vasculitis severity; therapy; and periods with no, moderate (lymphocyte count, 0.3–1.0× 109/L), or severe (lymphocyte count ≤ 0.3×109/L) lymphopenia and neutropenia (neutrophil count ≤ 1.5×109/L). Results One hundred patients had a mean age of 57±15 years and a Birmingham vasculitis activity score of 7.7±3.6. Therapy consisted of pulse methylprednisolone (59%), cyclophosphamide (85%), methotrexate (6%), and plasmapheresis (25%) in addition to oral corticosteroids. During follow-up, 53% of patients experienced infection and 28% were hospitalized for infection (severe infection). Only 18% experienced neutropenia, but 72% and 36% presented moderate and severe lymphopenia for a total duration of PPConclusions Lymphopenia is frequent during the treatment of AAV, and its severity is associated with the risk of infectious complications.This publication has 39 references indexed in Scilit:
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