非老年人中的微观多管炎:老年血管炎的诊断和治疗挑战
Leila C Tou1, Colleen Doyle1, Gregory Payne1
1Department of Internal Medicine, Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA.
Annals of geriatric medicine and research
|December 2, 2025
概括
微观多管炎 (MPA) 是老年人罕见的血管炎,具有诊断挑战. 早期识别和量身定制的治疗对于老年人管理这种情况至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 类风湿病学 类风湿病学
- 老年病的医生 老年病的医生
背景情况:
- 微观多炎 (MPA) 是一种罕见的ANCA相关血管炎.
- 在老年患者中,MPA带来了独特的诊断和治疗挑战.
研究的目的:
- 描述一个90岁的女性患有多种并发症的MPA病例.
- 突出MPA在老年人的诊断和治疗方面的考虑.
主要方法:
- 一个90岁的女性患有快速功能衰竭的病例报告.
- 评估包括MPO-ANCA测试和脏活检.
- 治疗涉及皮质类固醇,利图西马布和血液透析.
主要成果:
- 这位患者出现了和急性功能衰竭.
- 脏活检证实了乳腺免疫新月状丸炎.
- 治疗导致功能得到改善.
结论:
- 伴随性疾病可以掩盖老年人血管炎的症状.
- 当考虑对老年人的免疫抑制时,评估脆弱性至关重要.
- 建议在老年患者中对MPA保持警,这些老年患者有不明原因的衰退.
相关概念视频
Drug Dosing: Geriatric Patients
212
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
212
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
221
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
221
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
212
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
212
Pharmacodynamics in Geriatric Patients: Effects of Age
180
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
180
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
326
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
326
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
183
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
183


