Clinical features and outcomes of microscopic polyangiitis in the elderly
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Key words:microscopic polyangiitis  clinical feature  interstitial lung disease  prognosis  aged
Author NameAffiliationE-mail
JIN Xiao-Sheng1, WANG Wen-Yue1,3, CHENG Man-Man1, PENG Min1, ZHENG Wen-Jie2, YU Chang-Li1,3, SHI Ju-Hong1* 1Department of Respiratory Diseases, 2Department of Rheumatology and Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
3Department of Respiratory Diseases, North China Universty of Science and Technology, Tangshan 063000, China 
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      Objective To investigate the clinical features, outcome and influencing factors of microscopic polyangiitis (MPA) in the elderly patients. Methods Clinical data of 191 MPA patients admitted in our department from January 2007 to December 2012 were collected in this study. They were divided into ≥65 years old group and <65 years old group. Their clinical data were analyzed for the effect of age on the prognosis and survival. Cox regression analysis was employed to study the factors affecting survival. Results Diffuse alveolar hemorrhage (DAH) was more common in <65 years old group (P=0.004), while interstitial lung disease in ≥65 years old group (P=0.016) was more common. The incidence of renal failure (P=0.033) and the serum level of C-reactive protein (CRP; P=0.017) were significantly higher in ≥65 years old group than in <65 years old group . Kaplan-Meier survival analysis indicated that there was significant difference in the survival function between the 2 groups (Log-rank=10.462, P=0.001). Cox univariate analysis showed that age (HR: 1.04, P=0.002), leukocytes (HR: 0.65, P=0.000), CRP (HR: 1.01, P=0.006), creatinine (HR: 1.00, P=0.006), urea nitrogen (HR: 1.03, P=0.002), pulmonary infection (HR: 5.57, P=0.000), DAH (HR: 2.11, P=0.007) and Birmingham Vasculitis Activity Score (BVAS; HR: 1.12, P=0.000) were correlated with death. Cox multivariate analysis suggested that only age (HR: 1.02, P=0.003), pulmonary infection (HR: 3.79, P=0.040), DAH (HR: 5.02, P=0.004) and BAVS score (HR: 1.10, P=0.000) be high-risk factors for death. Conclusion MPA is common in the elderly, with no difference between genders. But the patients with older age have shorter survival time.