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Lymphopenia is a risk factor for severe infections in older patients with microscopic polyangiitis: a retrospective

Makoto Yamaguchi1, Hirokazu Sugiyama1, Hironobu Nobata1

  • 1Department of Nephrology and Rheumatology, Aichi Medical University, Nagakute, Aichi, Japan.

Rheumatology Advances in Practice
|September 11, 2023
PubMed
Abstract

Insights

Lymphopenia predicts severe infections in microscopic polyangiitis (MPA) patients on immunosuppressants. Close infection monitoring is crucial, especially for older individuals with low lymphocyte counts during treatment.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Clinical Immunology

Background:

  • Severe infections are a major complication in ANCA-associated vasculitis.
  • Lymphopenia's role as a predictor of severe infections in microscopic polyangiitis (MPA) requires further investigation.

Purpose of the Study:

  • To assess the association between lymphopenia and severe, hospitalization-requiring infections in MPA patients undergoing immunosuppressive therapy.

Main Methods:

  • A retrospective cohort study of 130 newly diagnosed MPA patients treated between 2004 and 2020.
  • Time-dependent multivariate Cox proportional hazard models were used to analyze the relationship between lymphopenia and severe infections.

Main Results:

  • During a median follow-up of 38 months, 39.2% of patients experienced severe infections.
  • Older age, methylprednisolone pulse therapy, moderate lymphopenia (HR=7.17), and severe lymphopenia (HR=36.1) were significant predictors of severe infection.

Conclusions:

  • Lymphopenia is a significant predictor of subsequent severe infections in MPA patients receiving immunosuppressive therapy.
  • Sustained infection surveillance is vital, particularly for older MPA patients who develop lymphopenia during intensive immunosuppressive treatment.
Keywords:
immunosuppressive therapyinfectionlymphopeniamethylprednisolone pulse therapymicroscopic polyangiitisvasculitis

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