Skip to main content

Advertisement

SpringerLink
Log in

ANCA-associated vasculitis (AAV) in the elderly: clinical presentation, treatment and outcomes

  • Brief Report
  • Published:
European Geriatric Medicine Aims and scope Submit manuscript

Abstract

Purpose

To explore treatment and outcomes in older patients with AAV.

Methods

Retrospective review (1 year) of patients > 75 years with positive MPO/PR3 antibodies.

Results

Thirty-nine evaluable patients had new positive MPO/PR3 antibodies. Nine patients had AAV and two possible AAV (2M, 9F mean age 82 years). Nine patients had renal impairment and three died during their presenting admission, all having required dialysis ± plasma exchange. Non-survivors had higher average creatinine (442 vs 265 µmol/L) and more co-morbidities (2 or more co-morbidities vs 0 or 1). All patients deemed fit received treatment, one discontinued (infection). Survival in AAV was 46% at 1 year and 18% at 2 years. 1/3 of positive MPO/PR3 results were not acknowledged in case records by clinicians.

Conclusions

Renal involvement is common in elderly patients with AAV. High creatinine, co-morbidity and need for dialysis are associated with a poorer prognosis. Mortality is high but survivors tolerate treatments well.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Watts RA, Lane SE, Bentham G et al (2000) Epidemiology of systemic vasculitis: a ten year study in the United Kingdom. Arthritis Rheumatol 43(2):414–419

    Article  CAS  Google Scholar 

  2. Mohammad AJ, Jacobsson LT, Westman KW et al (2009) Incidence and survival rates in Wegener’s granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome and polyarteritis nodosa. Rheumatology (Oxf) 48:1560–1565

    Article  Google Scholar 

  3. Harper L, Savage CO (2005) ANCA-associated renal vasculitis at the end of the twentieth century—a disease of older patients. Rheumatology 44:495–501

    Article  CAS  PubMed  Google Scholar 

  4. Weiner M, Mein Goh S, Mohammad AJ (2015) Outcome and treatment of elderly patients with ANCA-associated vasculits. Clin J Am Soc Nephrol 10(7):1128–1135

    Article  PubMed  PubMed Central  Google Scholar 

  5. Chen M, Yu F, Zhang Y et al (2008) Antineutrophil cytoplasmic autoantibody-associated vasculitis in older patients. Medicine (Baltim) 87(4):203–209

    Article  CAS  Google Scholar 

  6. Stone JH, Merkel PA, Spiera R (2010) Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med 363:221–232

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Jones RB, Tervaert JW, Hauser T et al (2010) Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med 363:211–220

    Article  CAS  PubMed  Google Scholar 

  8. Timlin H, Lee SM, Manno RL et al (2015) Rituximab for remission induction in elderly patients with ANCA-associated vasculitis. Semin Arthritis Rheum 45(1):67–69

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Bomback AS, Appel GB, Radhakrishnan J et al (2011) ANCA-associated glomerulonephritis in the very elderly. Kidney Int 79:757–764

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Respiratory Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, Scotland, G4 0SF, UK

    Gillian McVay & George W. Chalmers

  2. Rheumatology Department, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, Scotland, G4 0SF, UK

    Lucy McGeoch

Authors
  1. Gillian McVay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lucy McGeoch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. George W. Chalmers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gillian McVay.

Ethics declarations

Conflict of interest

Drs. McVay and McGeoch have no conflicts of interest or financial ties to disclose. Dr Chalmers has previously received consultancy fees from Roche and Boehringer Ingelheim.

Ethical approval

Ethical review was not required by our ethics department as this was an evaluation of our local service.

Research involving human participants and/or animals

For this type of study, formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McVay, G., McGeoch, L. & Chalmers, G.W. ANCA-associated vasculitis (AAV) in the elderly: clinical presentation, treatment and outcomes. Eur Geriatr Med 9, 725–728 (2018). https://doi.org/10.1007/s41999-018-0093-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41999-018-0093-8

Keywords

Search

Navigation