Damage occurs early in systemic vasculitis and is an index of outcome.
Because death after acute systemic vasculitis is now uncommon, alternative measures of outcome are required. A significant component of patient morbidity is disease-related damage, which can be quantified by the Vasculitis Damage Index (64 items in 11 organ-based systems). We investigated serially t...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
1997
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| _version_ | 1797058301221928960 |
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| author | Exley, A Carruthers, D Luqmani, R Kitas, G Gordon, C Janssen, B Savage, C Bacon, P |
| author_facet | Exley, A Carruthers, D Luqmani, R Kitas, G Gordon, C Janssen, B Savage, C Bacon, P |
| author_sort | Exley, A |
| collection | OXFORD |
| description | Because death after acute systemic vasculitis is now uncommon, alternative measures of outcome are required. A significant component of patient morbidity is disease-related damage, which can be quantified by the Vasculitis Damage Index (64 items in 11 organ-based systems). We investigated serially the time-course of damage in 120 patients with systemic vasculitis, to determine the earliest indicators of outcome. High damage scores at 2 years after presentation were characteristic of fatal disease (OR 8.1-12.4). Significant damage occurred within 6 months of presentation, and was a feature of fatal disease. More damage occurred after presentation than after relapse. Lung and multi-system damage were early indicators of poor outcome in severe non-fatal disease. Damage occurs early in systemic vasculitis, and is an indicator of poor outcome. This novel observation, together with evidence of persistent subclinical disease activity and the high frequency of relapse, suggests a need for new treatment strategies. Analogy with the management of acute leukaemia suggests a strategy of early diagnosis and intensive induction of remission, with early escalation of treatment for resistant disease. |
| first_indexed | 2024-03-06T19:48:32Z |
| format | Journal article |
| id | oxford-uuid:232ce3d3-bbb5-4ebb-b015-f4c0ee180d97 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:48:32Z |
| publishDate | 1997 |
| record_format | dspace |
| spelling | oxford-uuid:232ce3d3-bbb5-4ebb-b015-f4c0ee180d972022-03-26T11:42:53ZDamage occurs early in systemic vasculitis and is an index of outcome.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:232ce3d3-bbb5-4ebb-b015-f4c0ee180d97EnglishSymplectic Elements at Oxford1997Exley, ACarruthers, DLuqmani, RKitas, GGordon, CJanssen, BSavage, CBacon, PBecause death after acute systemic vasculitis is now uncommon, alternative measures of outcome are required. A significant component of patient morbidity is disease-related damage, which can be quantified by the Vasculitis Damage Index (64 items in 11 organ-based systems). We investigated serially the time-course of damage in 120 patients with systemic vasculitis, to determine the earliest indicators of outcome. High damage scores at 2 years after presentation were characteristic of fatal disease (OR 8.1-12.4). Significant damage occurred within 6 months of presentation, and was a feature of fatal disease. More damage occurred after presentation than after relapse. Lung and multi-system damage were early indicators of poor outcome in severe non-fatal disease. Damage occurs early in systemic vasculitis, and is an indicator of poor outcome. This novel observation, together with evidence of persistent subclinical disease activity and the high frequency of relapse, suggests a need for new treatment strategies. Analogy with the management of acute leukaemia suggests a strategy of early diagnosis and intensive induction of remission, with early escalation of treatment for resistant disease. |
| spellingShingle | Exley, A Carruthers, D Luqmani, R Kitas, G Gordon, C Janssen, B Savage, C Bacon, P Damage occurs early in systemic vasculitis and is an index of outcome. |
| title | Damage occurs early in systemic vasculitis and is an index of outcome. |
| title_full | Damage occurs early in systemic vasculitis and is an index of outcome. |
| title_fullStr | Damage occurs early in systemic vasculitis and is an index of outcome. |
| title_full_unstemmed | Damage occurs early in systemic vasculitis and is an index of outcome. |
| title_short | Damage occurs early in systemic vasculitis and is an index of outcome. |
| title_sort | damage occurs early in systemic vasculitis and is an index of outcome |
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