Diagnosis and Treatment of Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitides in 8 Elderly Pa-tients and Literature Review
- VernacularTitle:老年抗中性粒细胞胞浆抗体相关性血管炎诊治8例并文献复习
- Author:
Yihong DING
1
;
Gang LU
;
Wei LU
;
Yu ZHANG
;
Jianjun LIU
;
Weiying ZHU
;
Jianguo TANG
Author Information
1. 复旦大学附属上海市第五人民医院创伤急救危重医学中心
- Keywords:
Antineutrophil cytoplasmic autoantibody-associated vasculitides;
Glucocorticoid;
Cyclophosphamide
- From:
Chinese Journal of Clinical Medicine
2015;(2):228-230
- CountryChina
- Language:Chinese
-
Abstract:
To explore the clinical characteristics ,as well as diagnosis and treatment , of antineutrophil cytoplasmic autoantibody‐associated vasculitides (ANCA‐AAV )with pulmonary infection as the initial manifestation , by analyzing the clinical data of 8 elderly patients with ANCA‐AAV with pulmonary infection as the initial manifestation .Six patients ,who had received treatment of methylprednisolone 1 mg/(kg · d) for 4 to 6 weeks ,switched over to tapering prednisone .Three of the six cases received immunosuppressive cyclophosphamide 2 mg/(kg · d) orally for 1 year simultaneously ,of which one case received tripterygium wilfordii 1 mg/(kg · d) in addition for 3 months .The other two cases did not receive glucocorticoid therapy due to death caused by renal fallure .Among the 8 patients ,apart from 2 patients died in renal fallure and one case of death due to respiratory fallure ,5 patients got significant improvement on symptoms as cough ,sputum ,anemia ,fatigue , muscle aches ,and their body temperature returned to normal .Thus ,ANCA assay should be performed as early as possible for patients who had no specific clinical manifestation and showed no significant improvement to anti‐infection treatment . Administration of glucocorticoid may improve the prognosis of patients with ANCA‐AAV .
