Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study

Area of Science:

• Nephrology
• Immunology
• Infectious Diseases

Background:

• Anti-glomerular basement membrane (GBM) disease can lead to severe complications, with intensive therapy benefits debated due to infection risks.
• Understanding severe infection (SI) burden and predictors is crucial for managing anti-GBM disease patients.

Purpose of the Study:

• To describe the incidence and types of severe infections (SI) in a large cohort of anti-GBM disease patients.
• To identify factors predicting SI development in anti-GBM disease.
• To assess the impact of SI on mortality.

Main Methods:

• Retrospective analysis of 201 patients diagnosed with anti-GBM disease.
• Data collection on patient demographics, clinical presentation, and infection events within the first year.
• Multivariable analysis to identify predictors of SI and its association with mortality.

Main Results:

• 161 severe infections (SI) occurred in 116 patients within the first year.
• Pulmonary infections, catheter-associated bacteremia, and urinary tract infections were most common.
• Positive anti-neutrophil cytoplasmic antibodies (ANCA) and older age at diagnosis were independent predictors of SI.
• Age-adjusted SI within three months correlated with increased three-year mortality.

Conclusions:

• Severe infections are a frequent early complication in anti-GBM disease, particularly affecting the elderly and ANCA-positive individuals.
• The immunosuppressive strategy did not significantly influence SI occurrence.
• Identifying at-risk patients can guide preventative measures and treatment strategies.