Jeleniewicz Radosław
Klinika Reumatologii i Układowych Chorób Tkanki Łącznej, Uniwersytet Medyczny w Lublinie, Lublin, Polska.
Wiad Lek. 2019;72(9 cz 1):1691-1696.
Antineutrophil cytoplasmic antibodies (ANCA) play a key role in the pathogenesis of ANCA-associated vasculitides (AAV). These diseases are rare, occur in every age, but most commonly in adults and elder patients. Among them there are: granulomathosis with poyangiitis (GPA), microscopic poyangiitis (MPA) and eosinophilic granulomathosis with polyangiitis (EGPA). In the article we try to analyse the course of AAV in eldery patients, according to accessible literature. Among AAV patients, those with MPA diagnosis are elder than GPA and EGPA patients. Elder AAV patients present more frequently severe kidney and lung involvement. Elder patients are more at risk to develop complications in the course of disease, but also treatment-related, including severe infections. In elder patients immunosupresive agents dosage, therethore, should be tapered and adjusted to the renal function.
抗中性粒细胞胞浆抗体（ANCA）在ANCA相关性血管炎（AAV）的发病机制中起关键作用。这些疾病较为罕见，可发生于各个年龄段，但最常见于成人和老年患者。其中包括：肉芽肿性多血管炎（GPA）、显微镜下多血管炎（MPA）和嗜酸性肉芽肿性多血管炎（EGPA）。在本文中，我们试图根据现有文献分析老年患者AAV的病程。在AAV患者中，诊断为MPA的患者比GPA和EGPA患者年龄更大。老年AAV患者更常出现严重的肾脏和肺部受累。老年患者在疾病过程中发生并发症的风险更高，在治疗过程中也是如此，包括严重感染。因此，对于老年患者，免疫抑制剂的剂量应逐渐减少并根据肾功能进行调整。
