Elderly versus younger patients with microscopic polyangiitis vasculitis (MPA): a single-center retrospective study

Area of Science:

• Rheumatology
• Internal Medicine
• Vasculitis Research

Background:

• Microscopic polyangiitis (MPA) is a small-vessel necrotizing vasculitis.
• Age at onset may influence MPA's clinical presentation and treatment outcomes.
• Understanding these differences is crucial for tailored patient management.

Purpose of the Study:

• To compare the clinical presentation of MPA based on age at disease onset.
• To evaluate treatment response at six months in different age groups.
• To identify age-related disparities in MPA manifestation and management.

Main Methods:

• Retrospective analysis of 31 MPA patients diagnosed between 2015-2023.
• Patients categorized into younger (<65 years) and elderly (≥65 years) groups.
• Comparison of organ involvement, Birmingham Vasculitis Activity Score (BVAS), Vasculitis Damage Index (VDI), and 6-month treatment response.

Main Results:

• Younger patients (n=18) had higher BVAS scores and more frequent renal, pulmonary, and cutaneous involvement.
• Younger patients showed significant improvement in general, musculoskeletal, cutaneous, and pulmonary symptoms post-treatment.
• Elderly patients (n=13) presented with predominantly non-specific constitutional symptoms, with limited significant treatment response noted.

Conclusions:

• MPA exhibits distinct clinical presentations and treatment responses based on age at onset.
• Younger individuals experience more aggressive disease with better therapeutic outcomes.
• Elderly patients often present with subtle symptoms, potentially leading to delayed diagnosis and management challenges.