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[Wegener's granulomatosis in the elderly patient]
A L Fauchais1, M Michon-Pasturel, C Rugale
1Service de médecine interne, hôpital Claude-Huriez, CHRU, place de Verdun, 59037 Lille, France. alfauchais@aol.com
Purpose:
To determine aged-related variations in clinical and biological presentation and outcome in Wegener's granulomatosis.
Methods:
In a retrospective cohort study of 35 patients with a diagnosis of Wegener's granulomatosis, 24 patients (69%) younger than 60 years of age and 11 (31%) aged 60 years or older were compared for clinical and biological characteristics.
Results:
Clinical presentation was the same in the two groups; lymphopenia was more common in the elderly group (P > 0.05). Despite a similar treatment regime, outcome was significantly worse for the elderly group (> or = 60 years), with a mortality rate of 36% versus 8% in the control group. Mortality was essentially due to delayed infectious complications, raising the problem of a less intensive immunosuppressive treatment after remission.