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Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study
In patients presenting with anti-glomerular basement membrane (GBM) disease with advanced isolated kidney involvement, the benefit of intensive therapy remains controversial due to adverse events, particularly infection. We aim to describe the burden of severe infections (SI) (requiring hospitalizat...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141378/ https://www.ncbi.nlm.nih.gov/pubmed/32143501 http://dx.doi.org/10.3390/jcm9030698 |
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author | Caillard, Pauline Vigneau, Cécile Halimi, Jean-Michel Hazzan, Marc Thervet, Eric Heitz, Morgane Juillard, Laurent Audard, Vincent Rabant, Marion Hertig, Alexandre Subra, Jean-François Vuiblet, Vincent Guerrot, Dominique Tamain, Mathilde Essig, Marie Lobbedez, Thierry Quemeneur, Thomas Rebibou, Jean-Michel Ganea, Alexandre Peraldi, Marie-Noëlle Vrtovsnik, François Daroux, Maïté Lamrani, Adnane Makdassi, Raïfah Choukroun, Gabriel Titeca-Beauport, Dimitri |
author_facet | Caillard, Pauline Vigneau, Cécile Halimi, Jean-Michel Hazzan, Marc Thervet, Eric Heitz, Morgane Juillard, Laurent Audard, Vincent Rabant, Marion Hertig, Alexandre Subra, Jean-François Vuiblet, Vincent Guerrot, Dominique Tamain, Mathilde Essig, Marie Lobbedez, Thierry Quemeneur, Thomas Rebibou, Jean-Michel Ganea, Alexandre Peraldi, Marie-Noëlle Vrtovsnik, François Daroux, Maïté Lamrani, Adnane Makdassi, Raïfah Choukroun, Gabriel Titeca-Beauport, Dimitri |
author_sort | Caillard, Pauline |
collection | PubMed |
description | In patients presenting with anti-glomerular basement membrane (GBM) disease with advanced isolated kidney involvement, the benefit of intensive therapy remains controversial due to adverse events, particularly infection. We aim to describe the burden of severe infections (SI) (requiring hospitalization or intravenous antibiotics) and identify predictive factors of SI in a large cohort of patients with anti-GBM disease. Among the 201 patients (median [IQR] age, 53 [30–71] years) included, 74 had pulmonary involvement and 127 isolated glomerulonephritis. A total of 161 SI occurred in 116 patients during the first year after diagnosis. These infections occurred during the early stage of care (median [IQR] time, 13 [8–19] days after diagnosis) with mainly pulmonary (45%), catheter-associated bacteremia (22%) and urinary tract (21%) infections. In multivariable analysis, positive ANCA (HR [95% CI] 1.62 [1.07−2.44]; p = 0.02) and age at diagnosis (HR [95% CI] 1.10 [1.00–1.21]; p = 0.047) remained independently associated with SI. Age-adjusted severe infection during the first three months was associated with an increased three-year mortality rate (HR [95% CI] 3.13 [1.24–7.88]; p = 0.01). Thus, SI is a common early complication in anti-GBM disease, particularly in the elderly and those with positive anti-neutrophil cytoplasmic antibodies (ANCA). No significant association was observed between immunosuppressive strategy and occurrence of SI. |
format | Online Article Text |
id | pubmed-7141378 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-71413782020-04-10 Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study Caillard, Pauline Vigneau, Cécile Halimi, Jean-Michel Hazzan, Marc Thervet, Eric Heitz, Morgane Juillard, Laurent Audard, Vincent Rabant, Marion Hertig, Alexandre Subra, Jean-François Vuiblet, Vincent Guerrot, Dominique Tamain, Mathilde Essig, Marie Lobbedez, Thierry Quemeneur, Thomas Rebibou, Jean-Michel Ganea, Alexandre Peraldi, Marie-Noëlle Vrtovsnik, François Daroux, Maïté Lamrani, Adnane Makdassi, Raïfah Choukroun, Gabriel Titeca-Beauport, Dimitri J Clin Med Article In patients presenting with anti-glomerular basement membrane (GBM) disease with advanced isolated kidney involvement, the benefit of intensive therapy remains controversial due to adverse events, particularly infection. We aim to describe the burden of severe infections (SI) (requiring hospitalization or intravenous antibiotics) and identify predictive factors of SI in a large cohort of patients with anti-GBM disease. Among the 201 patients (median [IQR] age, 53 [30–71] years) included, 74 had pulmonary involvement and 127 isolated glomerulonephritis. A total of 161 SI occurred in 116 patients during the first year after diagnosis. These infections occurred during the early stage of care (median [IQR] time, 13 [8–19] days after diagnosis) with mainly pulmonary (45%), catheter-associated bacteremia (22%) and urinary tract (21%) infections. In multivariable analysis, positive ANCA (HR [95% CI] 1.62 [1.07−2.44]; p = 0.02) and age at diagnosis (HR [95% CI] 1.10 [1.00–1.21]; p = 0.047) remained independently associated with SI. Age-adjusted severe infection during the first three months was associated with an increased three-year mortality rate (HR [95% CI] 3.13 [1.24–7.88]; p = 0.01). Thus, SI is a common early complication in anti-GBM disease, particularly in the elderly and those with positive anti-neutrophil cytoplasmic antibodies (ANCA). No significant association was observed between immunosuppressive strategy and occurrence of SI. MDPI 2020-03-04 /pmc/articles/PMC7141378/ /pubmed/32143501 http://dx.doi.org/10.3390/jcm9030698 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Caillard, Pauline Vigneau, Cécile Halimi, Jean-Michel Hazzan, Marc Thervet, Eric Heitz, Morgane Juillard, Laurent Audard, Vincent Rabant, Marion Hertig, Alexandre Subra, Jean-François Vuiblet, Vincent Guerrot, Dominique Tamain, Mathilde Essig, Marie Lobbedez, Thierry Quemeneur, Thomas Rebibou, Jean-Michel Ganea, Alexandre Peraldi, Marie-Noëlle Vrtovsnik, François Daroux, Maïté Lamrani, Adnane Makdassi, Raïfah Choukroun, Gabriel Titeca-Beauport, Dimitri Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study |
title | Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study |
title_full | Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study |
title_fullStr | Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study |
title_full_unstemmed | Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study |
title_short | Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study |
title_sort | severe infection in anti-glomerular basement membrane disease: a retrospective multicenter french study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141378/ https://www.ncbi.nlm.nih.gov/pubmed/32143501 http://dx.doi.org/10.3390/jcm9030698 |
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