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Article Dans Une Revue Rheumatology Année : 2021

Impact of aging on phenotype and prognosis in IgA vasculitis

1 CHU Trousseau [Tours]
2 AP-HP - Hopital Saint-Louis [AP-HP]
3 CHU Caen
4 Centre hospitalier [Valenciennes, Nord]
5 CRCINA-ÉQUIPE 7 - Innate Immunity and Immunotherapy
6 LUNAM Université [Nantes Angers Le Mans]
7 Département de Néphrologie-Dialyse-Transplantation [CHU Angers]
8 CHU Angers - Centre Hospitalier Universitaire d'Angers
9 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
10 CHU La Réunion - Centre Hospitalier Universitaire de La Réunion
11 PIMIT - Processus Infectieux en Milieu Insulaire Tropical
12 HEGP - Hôpital Européen Georges Pompidou [APHP]
13 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
14 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
15 Service Néphrologie et transplantation rénale Adultes [CHU Necker]
16 UVSQ Santé - Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil
17 INFINITE (Ex-Liric) - Institute for Translational Research in Inflammation - U 1286
18 CHU Pitié-Salpêtrière [AP-HP]
19 GRC 14 - BIOSFAST - Groupe de recherche clinique Biomarqueurs d’urgence et de réanimation
20 CIC 1436 - Centre d'investigation clinique de Toulouse
21 Hôpital Ambroise Paré [AP-HP]
22 Service de médecine interne et gérontologie clinique [Angers]
23 MITOVASC - MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale
24 IC UM3 (UMR 8104 / U1016) - Institut Cochin
25 Service de Médecine Vasculaire [CHU Toulouse]
26 UPD5 - Université Paris Descartes - Paris 5
27 Hôpital Cochin [AP-HP]
28 HistIM - Plateforme Histologie, Immunomarquage et Microdissection laser [Institut Cochin]
Alexandra Audemard-Verger
Aurélie Baldolli
  • Fonction : Auteur
Johan Chanal
  • Fonction : Auteur

Résumé

Objectives Immunoglobulin A vasculitis (IgAV) is a small-vessel vasculitis most frequently benign in children while more severe in adults. We aimed to study the impact of age on presentation and outcome of adult IgAV. Methods We conducted a nationwide retrospective study including 260 IgAV patients. Patients were divided into four quartiles according to the age at IgAV diagnosis: <36, 36 ≤ age < 52; 52 ≤ age < 63 and ≥63 years. Comparison of presentation and outcome were performed according to age of disease onset. Results Mean age at diagnosis was 50.1 (18) years and 63% were male. IgAV diagnosed in the lowest quartile of age was associated with more frequent joint (P < 0.0001) and gastrointestinal involvement (P = 0.001). In contrast, the oldest patients had more severe purpura with necrotic lesions (P = 0.001) and more frequent renal involvement (P < 0.0001), with more frequent haematuria, renal failure, higher urine protein excretion and more frequent tubulointerstitial lesions. Patients were treated similarly in all groups of age, and clinical response and relapse rates were similar between groups. In the 127 treated patients with follow-up data for >6 months, clinical response and relapse rates were similar between the four groups. Median follow-up was of 17.2 months (9.1–38.3 months). Renal failure at the end of follow-up was significantly more frequent in the highest quartile of age (P = 0.02), but the occurrence of end-stage renal disease was similar in all groups. Last, overall and IgAV-related deaths were associated with increase in age. Conclusion Aging negatively impacts the severity and outcome of IgAV in adults. Younger patients have more frequent joint and gastrointestinal involvement, while old patients display more frequent severe purpura and glomerulonephritis.
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Dates et versions

hal-03775149 , version 1 (12-09-2022)

Identifiants

Citer

Alexandra Audemard-Verger, Evangéline Pillebout, Aurélie Baldolli, Noémie Le Gouellec, Jean-François Augusto, et al.. Impact of aging on phenotype and prognosis in IgA vasculitis. Rheumatology, 2021, 60 (9), pp.4245-4251. ⟨10.1093/rheumatology/keaa921⟩. ⟨hal-03775149⟩
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