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Severe infections in systemic necrotizing vasculitis
Claudia Pena1, Ana Carolina Costi1, Lucila García1
1Hospital Interzonal General de Agudos General José de San Martín, La Plata, Buenos Aires, Argentina.
Reumatologia Clinica
|May 31, 2024
Summary
Severe infections are common in vasculitis patients, affecting 34.2% and increasing mortality risk. Key factors include older age, lung/renal involvement, and high disease activity scores.
Area of Science:
- Rheumatology
- Infectious Diseases
- Clinical Medicine
Background:
- Infections are a leading cause of mortality in systemic vasculitis patients.
- Risk factors for infection include corticosteroid use, immunosuppression, age, organ involvement, and dialysis dependence.
Purpose of the Study:
- To determine the prevalence of severe infections in patients with ANCA-associated vasculitis (AAV) and Polyarteritis Nodosa (PAN).
- To identify factors associated with severe infections in these patient populations.
Main Methods:
- A retrospective study was conducted at a single rheumatology center from 2000-2018.
- Included patients diagnosed with AAV (GPA, EGPA, PAM) and PAN.
- Evaluated serious infectious events, sites of infection, causative microorganisms, and mortality.
Main Results:
- 34.2% of patients experienced severe infections, with a median of 3 months post-vasculitis diagnosis.
- Most common infection sites were lower respiratory tract (42.8%), sepsis (31.4%), and urinary tract (14.3%).
- Infections were significantly associated with age > 65, lung/renal involvement, and BVAS score > 15.
Conclusions:
- The prevalence of severe infection in AAV and PAN patients is 34.2%.
- Lower airway infections, sepsis, and UTIs are most common.
- Severe infections are linked to increased mortality, particularly in elderly patients with significant organ involvement and high disease activity.
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