{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:46:12Z","timestamp":1770813972229,"version":"3.50.1"},"reference-count":45,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T00:00:00Z","timestamp":1583280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In patients presenting with anti-glomerular basement membrane (GBM) disease with advanced isolated kidney involvement, the benefit of intensive therapy remains controversial due to adverse events, particularly infection. We aim to describe the burden of severe infections (SI) (requiring hospitalization or intravenous antibiotics) and identify predictive factors of SI in a large cohort of patients with anti-GBM disease. Among the 201 patients (median [IQR] age, 53 [30\u201371] years) included, 74 had pulmonary involvement and 127 isolated glomerulonephritis. A total of 161 SI occurred in 116 patients during the first year after diagnosis. These infections occurred during the early stage of care (median [IQR] time, 13 [8\u201319] days after diagnosis) with mainly pulmonary (45%), catheter-associated bacteremia (22%) and urinary tract (21%) infections. In multivariable analysis, positive ANCA (HR [95% CI] 1.62 [1.07\u22122.44]; p = 0.02) and age at diagnosis (HR [95% CI] 1.10 [1.00\u20131.21]; p = 0.047) remained independently associated with SI. Age-adjusted severe infection during the first three months was associated with an increased three-year mortality rate (HR [95% CI] 3.13 [1.24\u20137.88]; p = 0.01). Thus, SI is a common early complication in anti-GBM disease, particularly in the elderly and those with positive anti-neutrophil cytoplasmic antibodies (ANCA). No significant association was observed between immunosuppressive strategy and occurrence of SI.<\/jats:p>","DOI":"10.3390\/jcm9030698","type":"journal-article","created":{"date-parts":[[2020,3,4]],"date-time":"2020-03-04T10:46:08Z","timestamp":1583318768000},"page":"698","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Severe Infection in Anti-Glomerular Basement Membrane Disease: A Retrospective Multicenter French Study"],"prefix":"10.3390","volume":"9","author":[{"given":"Pauline","family":"Caillard","sequence":"first","affiliation":[{"name":"Department of Nephrology, Dialysis, and Transplantation, University of Picardie Jules Verne, Amiens University Hospital, F-80054 Amiens, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9cile","family":"Vigneau","sequence":"additional","affiliation":[{"name":"Department of Nephrology, CHU Pontchaillou, University Hospital, Rennes, France and University of Rennes 1, Institut National de la Sant\u00e9 Et de la Recherche M\u00e9dicale (INSERM) U1085-IRSET, F-35000 Rennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Michel","family":"Halimi","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Immunology, University Fran\u00e7ois-Rabelais, Bretonneau Hospital, CHU Tours and EA4245, F-37044 Tours, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Hazzan","sequence":"additional","affiliation":[{"name":"Nephrology Department, CHU of Lille, University of Lille, UMR 995, F-59000 Lille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Thervet","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Georges Pompidou European Hospital, Assistance Publique-H\u00f4pitaux de Paris (APHP), F-75015 Paris and INSERM UMRS970, F-92100 Boulogne-Billancourt, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morgane","family":"Heitz","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis and Renal Transplantation, University Hospital of Grenoble, F-38700 Grenoble, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurent","family":"Juillard","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Edouard Herriot Hospital, Hospices Civils de Lyon, Carmen INSERM 1060 and Univ Lyon, F-69437 Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5343-2550","authenticated-orcid":false,"given":"Vincent","family":"Audard","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Reference Center-Idiopathic Nephrotic Syndrome, Henri-Mondor Hospital\/Albert-Chenevier, APHP F-94000 Cr\u00e9teil, INSERM U955, Paris Est Cr\u00e9teil University, F-94000 Cr\u00e9teil, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5696-6478","authenticated-orcid":false,"given":"Marion","family":"Rabant","sequence":"additional","affiliation":[{"name":"Pathology Department, Necker University Hospital, AP-HP. Centre-Universit\u00e9 de Paris, F-75015 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Hertig","sequence":"additional","affiliation":[{"name":"Sorbonne University, APHP, Renal Intensive Care Unit, Tenon Hospital, F-75020 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Fran\u00e7ois","family":"Subra","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis and Transplantation, University Hospital, Angers and CRCINA, INSERM, Universit\u00e9 de Nantes, Universit\u00e9 d\u2019Angers, F-49100 Angers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Vuiblet","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, Reims University Hospital, F-51092 Reims, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominique","family":"Guerrot","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rouen University Hospital, Rouen and INSERM, U1096 Rouen, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathilde","family":"Tamain","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis and Renal Transplantation, University Hospital, F-63000 Clermont-Ferrand, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Essig","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis, and Renal Transplantation, University Hospital, F-87000 Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Lobbedez","sequence":"additional","affiliation":[{"name":"Department of Nephrology, F-14000 Caen University Hospital, Caen, France and the French Registry of Peritoneal Dialysis, Langue Fran\u00e7aise, F-95300 Pontoise, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Quemeneur","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Internal Medicine, Valenciennes General Hospital, F-59300 Valenciennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Michel","family":"Rebibou","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis and Renal Transplantation, University Hospital, F-21000 Dijon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Ganea","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Orleans Hospital, F-45100 Orleans, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-No\u00eblle","family":"Peraldi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis and Renal Transplantation, Saint-Louis Hospital, AP-HP, Paris and Paris Diderot University, UMR S-1160 alloimmunite-autoimmunite-transplantation (A2T), F-75010 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Vrtovsnik","sequence":"additional","affiliation":[{"name":"Nephrology Department, Bichat-Claude Bernard Hospital, APHP, Paris, France. Faculty of Medicine, Paris Diderot University, Sorbonne Paris Cit\u00e9, F-75018 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u00eft\u00e9","family":"Daroux","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Duchenne Hospital, F-62200 Boulogne-Sur-Mer, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnane","family":"Lamrani","sequence":"additional","affiliation":[{"name":"Biostatistics Department, Clinical Research and Innovation Department, Amiens University Hospital, F-80054 Amiens, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ra\u00effah","family":"Makdassi","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis, and Transplantation, University of Picardie Jules Verne, Amiens University Hospital, F-80054 Amiens, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Choukroun","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis, and Transplantation, University of Picardie Jules Verne, Amiens University Hospital, F-80054 Amiens, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2514-4193","authenticated-orcid":false,"given":"Dimitri","family":"Titeca-Beauport","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis, and Transplantation, University of Picardie Jules Verne, Amiens University Hospital, F-80054 Amiens, France"},{"name":"Department of Nephrology, Dialysis, and Transplantation, Amiens University Hospital, F-80054 Amiens, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,4]]},"reference":[{"key":"ref_1","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":"Falk","year":"2013","journal-title":"Arthritis Rheum."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1681\/ASN.V641178","article-title":"Identification of the alpha 3 chain of type IV collagen as the common autoantigen in antibasement membrane disease and Goodpasture syndrome","volume":"6","author":"Kalluri","year":"1995","journal-title":"J. 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