Clinical analysis of eosinophilic granulomatosis with polyangiitis in elderly patientsZhang Jun1， Li Jie1， Wang Jing1， Hua Lin2, Zhang Liming1*

doi:10.3969/j.issn.1006-7795.2024.03.021

Abstract

Abstract: Objective To analyze the clinical features of eosinophilic granulomatosis with polyangiitis (EGPA) in elderly patients. Methods The clinical data of patients diagnosed with EGPA at Beijing Chaoyang Hospital, Capital Medical University from February 2007 to February 2022 were retrospectively analyzed. The patients were divided into the elderly group (age ≥60 years old at diagnosis) and the non-elderly group (age<60 years old at diagnosis). Clinical features between the 2 groups were compared and the prognosis was followed up. Results A total of 101 patients were included, with 42 cases (41.6%) in the elderly group and 59 cases (58.4%) in the non-elderly group. Compared with the non-elderly group, the elderly group had significantly higher proportion of hypertension (40.5% vs 16.9%, P=0.008), blood eosinophils>10% (90.5% vs 72.9%, P=0.029) and estimated glomerular filtration rate (eGFR)<80 mL·min^－1·(1.73 m2)^－1 (61.9% vs 16.9%, P<0.001), and also had significantly higher erythrocyte sedimentation rate (ESR) ［20(10, 56.25) vs 12(5, 32.25) mm/h, P=0.028］ and lung functional parameter of residual volume/total lung capacity (RV/TLC) ［ (48.84±11.43) vs (41.92±9.06) %, P=0.009］. Compared with the non-elderly group，the incidence of cardiac involvement (73.8% vs 32.2%, P<0.001), central nervous system involvement (23.8% vs 5.1%, P=0.006), peripheral nervous system lesions（83.3% vs 64.4%, P=0.036）, kidney involvement（69.0% vs 47.5%, P=0.031）and five-factor scores (FFS) ≥2（61.9% vs 15.3%, P<0.001）were all significantly higher in the elderly group. The median follow-up time was 41 (19, 59) months, 6 patients died and the mortality rate in the elderly group was higher than that in the non-elderly group (13.9% vs 1.92%, P=0.032). Conclusion The elderly EGPA patients have higher proportion of hypertension, blood eosinophils >10% and decreased eGFR, the organs involved and FFS ≥2, higher ESR, RV/TLC and mortality rate. Clinicians should reinforce their understanding of characteristics of EGPA in elderly patients so as to improve the diagnostic and treatment proficiency.

Key words: eosinophilic granulomatosis with polyangiitis, elderly patlents, clinical features

CLC Number:

R543

Zhang Jun, Li Jie, Wang Jing, Hua Lin, Zhang Liming. Clinical analysis of eosinophilic granulomatosis with polyangiitis in elderly patientsZhang Jun1， Li Jie1， Wang Jing1， Hua Lin2, Zhang Liming1*[J]. Journal of Capital Medical University, 2024, 45(3): 515-523.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2024.03.021

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2024/V45/I3/515

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