RT Journal Article
SR Electronic
T1 Challenges in the management of patients with ANCA- associated vasculitides
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2376
VO 40
IS Suppl 56
A1 Ionela Nicoleta Belaconi
A1 Claudia Lucia Toma
A1 Stefan Dumitrache-Rujinski
A1 Cornelia Tudose
A1 Diana Leonte
A1 Miron Alexandru Bogdan
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P2376.abstract
AB Background: Granulomatosis with polyangiitis (Wegener's) and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA) – associated vasculitides with significant morbidity and mortality.Objective: We evaluated the evolution of 12 patients diagnosed in our clinic between 2000 and 2011, treated with conventional treatment (prednisolone and pulse cyclophosphamide initially, and in remission with prednisolone and azathioprine).Results: We evaluated 12 patients (10 females), median age of 46 years (range 20-74), with a median duration of follow up of 5.2 years (range 1-12 years).Six patients had relapses (50%), 1 developed subglottic stenosis, 1 retro-orbital pseudo tumor and 2 patients developed lung abscesses inside a cavity which imposed lobectomy after unsuccessful antibiotic treatment. Two patients developed lung tuberculosis (one multi-drug-resistant) and 1 pulmonary nocardiosis linked to the immunosuppressive therapy. Two patients needed peritoneal dialysis for renal failure. Two patients died of stroke (1) and severe active vasculitis (1). Older age and renal failure were predictors of death.Conclusions: The management of patients with ANCA-associated vasculitides is difficult, and marked by significant adverse effects of the therapy.