title: Inflammatory response in an immunosuppressed patient with Wegener's granulomatosis.
abstract: BACKGROUND
  The use of cardiopulmonary bypass (CPB) triggers a systemic inflammatory response (IR), but it is not known if a similar response occurs in an immunosuppressed patient with autoimmune disease.
  
  
  RESULTS
  Observational study in a 56-year-old man receiving immunosuppressive therapy for Wegener's granulomatosis (WG) who underwent aortic valve replacement on CPB. The following markers for IR were studied in the perioperative period: C3a, C5a, neutrophil elastase (NE), interleukin eight (IL-8), white cell count (WCC) and C-reactive protein (CRP). Results were compared with published literature on the IR in patients undergoing coronary revascularisation with and without the use of CPB. All inflammatory markers increased in the perioperative period. The intensity of IR was markedly reduced compared to published literature for patients undergoing coronary revascularisation on CPB and the temporal patients and extend resembled that for off-pump.
  
  
  CONCLUSIONS
  In a patient with WG on immunosuppressive therapy the CPB-related IR is reduced.
authors.affiliation: Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK. niloogan@yahoo.co.uk
authors.forename: Saeed
authors.initials: S
authors.lastname: Mirsadraee
authors.forename: Alexander
authors.initials: A
authors.lastname: Fraser
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kerr
authors.forename: Teifi E
authors.initials: TE
authors.lastname: James
authors.forename: Carin
authors.initials: C
authors.lastname: van Doorn
mesh_terms: D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D015926:Complement C3a / Q000032:analysis; D015936:Complement C5a / Q000032:analysis; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000628:therapy*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D016209:Interleukin-8 / Q000097:blood; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008875:Middle Aged; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000209:etiology
chemical_list: D016209:Interleukin-8; D015926:Complement C3a; D015936:Complement C5a; D019272:Leukocyte Elastase