{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:11:31Z","timestamp":1787497891378,"version":"build-2736575974"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"vor","delay-in-days":241,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Previous studies have identified the predictors of severe infections in ANCA-associated vasculitis. However, lymphopenia has not been fully evaluated as a predictor of subsequent severe infections in patients with microscopic polyangiitis (MPA). The aim of this study was to assess the association between lymphopenia and severe infections requiring hospitalization after receiving immunosuppressive therapy for MPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-centre retrospective cohort study included 130 consecutive patients with newly diagnosed MPA from Aichi Medical University Hospital, Japan, who received immunosuppressive therapy between March 2004 and December 2020. The relationship between lymphopenia and subsequent severe infections was assessed using time-dependent multivariate Cox proportional hazard models adjusted for clinically relevant factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the follow-up period (median: 38\u2009months; interquartile range: 15\u201363\u2009months), 56 severe infectious episodes occurred in 51 patients (39.2%). Time-dependent multivariate Cox proportional hazard analyses identified older age [adjusted hazard ratio (HR)\u2009=\u20091.74 per 10\u2009years, 95% CI: 1.13, 2.67], methylprednisolone pulse therapy (adjusted HR\u2009=\u20092.04, 95% CI: 1.03, 4.02), moderate lymphopenia (vs normal, adjusted HR\u2009=\u20097.17, 95% CI: 3.10, 16.6) and severe lymphopenia (vs normal, adjusted HR\u2009=\u200936.1, 95% CI: 11.8, 110.9) as significant predictors of severe infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lymphopenia is a predictor of subsequent severe infections in patients with MPA who receive immunosuppressive therapy. These results suggest the importance of sustained infection surveillance, particularly in older patients who develop lymphopenia during strong immunosuppressive therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rap\/rkad073","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T08:19:02Z","timestamp":1693297142000},"source":"Crossref","is-referenced-by-count":5,"title":["Lymphopenia is a risk factor for severe infections in older patients with microscopic polyangiitis: a retrospective cohort study in Japan"],"prefix":"10.1093","volume":"7","author":[{"given":"Makoto","family":"Yamaguchi","sequence":"first","affiliation":[{"name":"Department of Nephrology and Rheumatology, Aichi Medical University , Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokazu","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Aichi Medical University , Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironobu","family":"Nobata","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Aichi Medical University , Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kinashi","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Aichi Medical University , Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akimasa","family":"Asai","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Aichi Medical University , Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiya","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Aichi Medical University , Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Katsuno","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Aichi Medical University , Nagakute, Aichi, Japan"},{"name":"Department of Nephrology and Rheumatology, Aichi Medical University Medical Center , Okazaki, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Ando","sequence":"additional","affiliation":[{"name":"Data Coordinating Center, Department of Advanced Medicine, Nagoya University Hospital , Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Kubo","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Nagoya University Graduate School of Medicine , Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shogo","family":"Banno","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Aichi Medical University , Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiko","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Aichi Medical University , Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9861-5331","authenticated-orcid":false,"given":"Takuji","family":"Ishimoto","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Rheumatology, Aichi Medical University , Nagakute, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"2023090704034576900_rkad073-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/art.37715","article-title":"2012 revised International Chapel Hill Consensus conference nomenclature of vasculitides","volume":"65","author":"Jennette","year":"2013","journal-title":"Arthritis Rheum"},{"key":"2023090704034576900_rkad073-B2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/art.1780370206","article-title":"Nomenclature of systemic vasculitides. 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