Comparison of the clinicopathological characteristics of children with anti-neutrophil cytoplasmic antibody-associated vasculitis with/without infection at diagnosis
Abstract Background Infectious episodes contribute to morbidity and mortality in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Renal involvement, also known as ANCA-associated glomerulonephritis (AGN), is frequently observed in AAV. Little is known about whet...
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BMC
2025-01-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-024-03919-x |
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| author | Li-Li Long Mei Tan Hui Deng Hui Tang Xiao-Qing Lin Miao Zhang Hui-Ying Deng Xia Gao |
| author_facet | Li-Li Long Mei Tan Hui Deng Hui Tang Xiao-Qing Lin Miao Zhang Hui-Ying Deng Xia Gao |
| author_sort | Li-Li Long |
| collection | DOAJ |
| description | Abstract Background Infectious episodes contribute to morbidity and mortality in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Renal involvement, also known as ANCA-associated glomerulonephritis (AGN), is frequently observed in AAV. Little is known about whether co-infection at initial diagnosis is associated with renal outcome and prognosis in children with AGN. Methods Clinical and prognostic data for children admitted to our center with AAV from January 2001 to August 2023 were analyzed retrospectively. We compared the incidence of end-stage renal disease (ESRD) and mortality according to infection status at initial diagnosis. Results A total of 33 children with AGN were included in this study, 22 had an infection at the time of AGN diagnosis. A trend toward higher levels of proteinuria in the infected group than in the non-infected group was observed (p = 0.42). Patients in the infected group had higher creatinine and lower eGFR values than those in the non-infected group (p = 0.09). A significant decrease in HGB was observed in the infected group (p < 0.05). There were no significant differences in the baseline values of ALB and complement c3 between the two groups. A similar proportion of patients in both groups required dialysis at the time of diagnosis (27.3% vs. 31.8%). Patients with infection presented with significantly greater ESR and CRP levels (p < 0.05), and the most commonly infected site was the lung. After 6 months of treatment, compared with those in the non-infected group, the median levels of creatinine and proteinuria were higher in the infected group. Besides, lower levels of eGFR and ALB were also observed in the infected group. 5 (45.5%) and 13 (59.1%) patients died or progressed to ESRD, respectively, in the non-infected group and infected group at the last follow-up. Conclusions Infection at initial diagnosis does not affect the outcomes of children with AGN, although it could lead to a reduction in kidney function. |
| format | Article |
| id | doaj-art-dd186c7a4630448c93e2389e6f908307 |
| institution | Kabale University |
| issn | 1471-2369 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj-art-dd186c7a4630448c93e2389e6f9083072025-01-12T12:11:35ZengBMCBMC Nephrology1471-23692025-01-012611710.1186/s12882-024-03919-xComparison of the clinicopathological characteristics of children with anti-neutrophil cytoplasmic antibody-associated vasculitis with/without infection at diagnosisLi-Li Long0Mei Tan1Hui Deng2Hui Tang3Xiao-Qing Lin4Miao Zhang5Hui-Ying Deng6Xia Gao7Department of Nephrology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Nephrology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Nephrology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Nephrology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Nephrology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Nephrology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Nephrology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityDepartment of Nephrology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical UniversityAbstract Background Infectious episodes contribute to morbidity and mortality in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Renal involvement, also known as ANCA-associated glomerulonephritis (AGN), is frequently observed in AAV. Little is known about whether co-infection at initial diagnosis is associated with renal outcome and prognosis in children with AGN. Methods Clinical and prognostic data for children admitted to our center with AAV from January 2001 to August 2023 were analyzed retrospectively. We compared the incidence of end-stage renal disease (ESRD) and mortality according to infection status at initial diagnosis. Results A total of 33 children with AGN were included in this study, 22 had an infection at the time of AGN diagnosis. A trend toward higher levels of proteinuria in the infected group than in the non-infected group was observed (p = 0.42). Patients in the infected group had higher creatinine and lower eGFR values than those in the non-infected group (p = 0.09). A significant decrease in HGB was observed in the infected group (p < 0.05). There were no significant differences in the baseline values of ALB and complement c3 between the two groups. A similar proportion of patients in both groups required dialysis at the time of diagnosis (27.3% vs. 31.8%). Patients with infection presented with significantly greater ESR and CRP levels (p < 0.05), and the most commonly infected site was the lung. After 6 months of treatment, compared with those in the non-infected group, the median levels of creatinine and proteinuria were higher in the infected group. Besides, lower levels of eGFR and ALB were also observed in the infected group. 5 (45.5%) and 13 (59.1%) patients died or progressed to ESRD, respectively, in the non-infected group and infected group at the last follow-up. Conclusions Infection at initial diagnosis does not affect the outcomes of children with AGN, although it could lead to a reduction in kidney function.https://doi.org/10.1186/s12882-024-03919-xAnti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitisInfectionEnd-stage renal disease |
| spellingShingle | Li-Li Long Mei Tan Hui Deng Hui Tang Xiao-Qing Lin Miao Zhang Hui-Ying Deng Xia Gao Comparison of the clinicopathological characteristics of children with anti-neutrophil cytoplasmic antibody-associated vasculitis with/without infection at diagnosis BMC Nephrology Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis Infection End-stage renal disease |
| title | Comparison of the clinicopathological characteristics of children with anti-neutrophil cytoplasmic antibody-associated vasculitis with/without infection at diagnosis |
| title_full | Comparison of the clinicopathological characteristics of children with anti-neutrophil cytoplasmic antibody-associated vasculitis with/without infection at diagnosis |
| title_fullStr | Comparison of the clinicopathological characteristics of children with anti-neutrophil cytoplasmic antibody-associated vasculitis with/without infection at diagnosis |
| title_full_unstemmed | Comparison of the clinicopathological characteristics of children with anti-neutrophil cytoplasmic antibody-associated vasculitis with/without infection at diagnosis |
| title_short | Comparison of the clinicopathological characteristics of children with anti-neutrophil cytoplasmic antibody-associated vasculitis with/without infection at diagnosis |
| title_sort | comparison of the clinicopathological characteristics of children with anti neutrophil cytoplasmic antibody associated vasculitis with without infection at diagnosis |
| topic | Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis Infection End-stage renal disease |
| url | https://doi.org/10.1186/s12882-024-03919-x |
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