Prognostic factors in Wegener's granulomatosis

Abstract

Summary:We analysed data from 64 patients with Wegener's granulomatosis to determine predictor variables of outcome. The mean period of observation after the diagnosis had been established was 3.2 (range 0.1-11.2) years. At the time of diagnosis, 15 (23%) patients had only local symptoms. The disease was generalized to multiple organs in 49 (77%) patients. Renal biopsies were obtained in 33 patients; 13 (39%) had extracapillary glomerulonephritis, which was the most common renal lesion. All but three patients received immunosuppressive therapy. At time of follow-up, 17 (27%) patients were in complete, and 26 (40%) in partial remission. We employed a Kaplan Meier analysis to identify predictor variables of outcome. Renal involvement, initial creatinine concentration, serum albumin or total protein concentration, leukocyte count and erythrocyturia proved to be predictor variables. These variables may be of value in guiding the intensity of treatment in patients with Wegener's granulomatosis.

Long-term outcome of 37 patients with Wegener's granulomatosis with renal involvement

“…The results of our analysis show that serum creatinine at diagnosis was a strong predictor of renal outcome: patients with These results are consistent with earlier findings [3][4][5][6]11], but indicate that the creatinine cutoff point associated with poor outcome may be lower than hitherto suspected. Previous reports mentioned cutoff points of 160 [5], 170 [11], and 310 μmol/L [18].…”

“…Previous studies [5,14,15] showed that patients with generalized WG had shorter life expectancies than patients with limited disease. Increased mortality rates may be related to disease extent and severity and to increased treatment-related morbidity due to higher cumulative doses of CYC and CS.…”

“…Although initially described as a triad, involvement of all sites varies; renal disease is diagnosed in 18% [1] to 85% [2] of patients at initial diagnosis. When renal involvement is present, it is considered to be an important determinant of prognosis and is associated with a high risk of end-stage renal disease (ESRD) and death [3][4][5][6].…”

Wegener’s Granulomatosis with Parotid Gland Involvement and Pneumothorax

“…Our patient had multiple organ involvement. Renal disease or impaired renal function, pulmonary involvement, advanced age, anemia and initial white blood cell count over than 10,000/Ìl are reported to be bad prognostic factors [19][20][21][22][23].…”

Wegeners granulematosis (clinical case in practice)

“…Среди возмож-ных причин возникновения ГВ наиболее вероятным считают микробный или вирусный фактор [8]. Заболе-вание нередко возникает после ОРВИ, переохлаждения, вакцинации, антибиотикотерапии, но может развиваться и у совершенно здоровых людей [3,7]. Вследствие пря-мого воздействия этиологического фактора формируется чужеродный антиген или аутоантиген, которые вызывают клеточный или гуморальный иммунный ответ.…”