Management of Elderly Patients with Rapidly Progressive Glomerulonephritis

Hrušková, Zdenka; Tesař, Vladimı́r

doi:10.1159/000485368

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…Although in our case there was a clear temporal relationship between diagnosis of GCT and AAV, considering the slowly progressing growth of GCT it is possible that the tumor had been present long before manifestation of AAV. Besides that, our patient was in the age group between 65 and 74 years, which is reported to be the peak incidence rate age group for diagnosis of AAV [14].…”

Section: Discussionmentioning

confidence: 64%

An unusual cause of rapidly progressive glomerulonephritis associated with ANCA vasculitis and ovarian malignancy – a relapse 39 years after initial treatment

Simovic¹,

Djuric²,

Stojšić³

et al. 2023

cejoi

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a 69-year-old woman presented with severe anemia, proteinuria, microscopic hematuria and rapidly progressive renal failure. She was admitted to the nephrology department due to severe deterioration of renal function with complaints of malaise, fever, dry cough and occasional epistaxis that appeared 2 months prior to admission. Histopathologic examination of a specimen from kidney biopsy and immunologic findings revealed aNCa positive pauci-immune crescentic glomerulonephritis. the patient had a history of ovarian granulosa cell tumor and lung metastases that were treated surgically with postoperative radiotherapy and chemotherapy. thoracic computed tomography showed tissue neoplasm in the right lung and ultrasound-guided percutaneous transthoracic biopsy confirmed granulosa cell tumor. that was a relapse, thirty-nine years after initial treatment of malignant disease and twenty-four years after surgical resection of metastases from both lungs. although the association between malignancy and vasculitis has been well known for decades, this is the first described case of aNCa vasculitis associated with any type of gynecological malignancy and glomerulonephritis.

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Section: Discussionmentioning

confidence: 64%

An unusual cause of rapidly progressive glomerulonephritis associated with ANCA vasculitis and ovarian malignancy – a relapse 39 years after initial treatment

Simovic¹,

Djuric²,

Stojšić³

et al. 2023

cejoi

View full text Add to dashboard Cite

show abstract

“…In the present study, higher serum creatinine was a significant risk factor for all-cause mortality in the elderly group. AAV-associated kidney involvement often presents as rapidly progressive GN [ 28 ] and can cause poor morbidities and mortality. Therefore, if elderly patients with AAV have kidney involvement or impaired renal function, meticulous care and close follow-up and monitoring are needed.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes of elderly patients with antineutrophil cytoplasmic antibody-positive vasculitis: a single-center retrospective study

Kim

Song

Seong

2022

Kidney Res Clin Pract

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BackgroundWe aimed to investigate the clinical characteristics and outcomes of patients aged ≥65 years with antineutrophil cytoplasmic autoantibody (ANCA)-positive ANCA-associated vasculitis (AAV) in Korea.MethodsSeventy patients diagnosed with ANCA-positive AAV from 2006 to 2019 at a single center were analyzed and categorized into younger (aged <65 years) or elderly (aged ≥65 years) groups. Initial induction treatments were investigated according to age group. All-cause mortality and kidney outcomes were evaluated.ResultsAfter categorization by age, 34 (48.6%) and 36 patients (51.4%) were in the younger and elderly groups, respectively. In the elderly group, more patients were treated with oral cyclophosphamide (CYC) (30.6%) than with intravenous CYC (19.4%). During a median follow-up of 14.6 months (range, 3.0-53.1 months), 13 patients died (elderly group: 11 patients, 84.6%). In the elderly group, older age (hazard ratio [HR], 1.44; 95% confidence interval [CI], 1.09-1.90; p = 0.01), lower hemoglobin (HR, 0.21; 95% CI, 0.08-0.60; p = 0.003), and higher serum creatinine level (HR 14.17; 95% CI, 1.29-155.84; p = 0.03) were significant risk factors for all-cause mortality after adjustment. Oral CYC + steroid treatment was associated with decreased all-cause mortality compared to untreated induction immunosuppressants (HR, 0.01; 95% CI, 0.0003-0.47; p = 0.02). Kidney failure or renal recovery outcomes were not significantly different between the younger and elderly groups.ConclusionPatients aged ≥65 years had higher mortality rates than younger patients, and mortality was associated with older age, lower hemoglobin, higher serum creatinine level, and nontreatment compared to oral CYC + steroids.

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“…III. Pauci-imuninis (neimuninis), sąlygotas antineutrofilinių citoplazminių antikūnų (ANCA) asocijuoto smulkiųjų kraujagyslių vaskulito [2][3].…”

Section: Sveikatos Mokslai / Health Sciences In Eastern Europeunclassified

Retas Lėtinės Limfocitinės B Ląstelių Leukemijos (Smulkių B Limfocitų Limfomos) Ir Greitai Progresuojančio Glomerulonefrito Ryšys. Klinikinis Atvejis

Kybartienė-Mačiulaitė¹,

Janonytė²,

Baldauskaitė³

2023

Health Sciences

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Greitai progresuojantis glomerulonefritas (GPGN) – klinikinis sindromas, kuriam būdinga staiga atsiradęs ir greitai progresuojantis inkstų funkcijos nepakankamumas, hipertenzija, proteinurija ir hematurija. GPNG yra reta onkologinių ligų komplikacija. Yra įrodymų, kad pacientams, kuriems diagnozuotas ANCA vaskulitas, piktybinių navikų pasitaiko dažniau, lyginant su pacientais, sergančiais kitų formų vaskulitais. Šiame straipsnyje pristatomas neimuninio, ANCA teigiamo GPGN klinikinis atvejis, galimai sąlygotas B smulkių limfocitų leukemijos (limfomos). Pacientas kreipėsi į LSMUL KL dėl sauso kosulio, dusulio ir tamsaus šlapimo. SPS atliktuose tyrimuose ureminiai rodikliai buvo žymiai padidėję, gautas teigiamas COVID – 19 rezultatas. Paciento būklė įvertinta kaip ŪIFN, pradėta skubi hemodializė. Iš pradžių manyta, jog ŪIFN išsivystė dėl COVID – 19 ligos sukeltų pakitimų. LSMUL KK Nefrologijos skyriuje dėl diagnozės patikslinimo atlikta inksto biopsija. Nustatyta: židininis pusmėnulinis ir sklerozuojantis glomerulonefritas be imunoreaktantų depozicijos glomeruluose bei B smulkių limfocitų limfoma (leukemija). Įvertinus klinikinius, laboratorinius ir instrumentinius duomenis, nuspręsta pradėti pulsterapiją metilprednizolonu. Vėliau pradėta imunochemoterapija. GPGN, susijusio su LLL, prognozė ir atsakas į gydymą nėra iki galo aiškūs. Aprašomi tik pavieniai atvejai, kuomet IFN regresavo.

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Management of Elderly Patients with Rapidly Progressive Glomerulonephritis

Cited by 5 publications

References 34 publications

An unusual cause of rapidly progressive glomerulonephritis associated with ANCA vasculitis and ovarian malignancy – a relapse 39 years after initial treatment

An unusual cause of rapidly progressive glomerulonephritis associated with ANCA vasculitis and ovarian malignancy – a relapse 39 years after initial treatment

Clinical features and outcomes of elderly patients with antineutrophil cytoplasmic antibody-positive vasculitis: a single-center retrospective study

Retas Lėtinės Limfocitinės B Ląstelių Leukemijos (Smulkių B Limfocitų Limfomos) Ir Greitai Progresuojančio Glomerulonefrito Ryšys. Klinikinis Atvejis

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