Description

Yamaguchi et al identified risk factors for severe infection in a patient with ANCA-associated vasculitis receiving immunosuppressive therapy. These can help to identify a patient who may require more aggressive management. The authors are from Aichi Medical University in Japan.


ANCA-associated vasculitis: microscopic polyangiitis, granulomatosis with polyangiitis (Wegener's), eosinophilic granulomatosis with polyangiitis (Churg Strauss)

 

Patient selection: immunosuppressive therapy for ANCA-associated vasculitis

 

Severe infections: bacterial pneumonia, Pneumocystis jiroveci pneumonia, bacterial osteomyelitis, MRSA bacteremia, invasive aspergillosis, miliary tuberculosis, fungemia and pyelonephritis.

 

Predictors of severe infection:

(1) hypoalbuminemia (hazard ratio 0.38 or 0.45 per 1 g/dL)

(2) methylprednisolone pulse therapy (0.5 to 1.0 g per day for 3 days, hazard ratio 5.4)

(3) oral candidiasis (hazard ratio 5.3)


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