Inflammatory response in an immunosuppressed patient with Wegener's granulomatosis.
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.
Mirsadraee
Saeed
S
Yorkshire Heart Centre, Leeds General Infirmary, Leeds, UK. niloogan@yahoo.co.uk
Fraser
Alexander
A
Kerr
Michael A
MA
James
Teifi E
TE
van Doorn
Carin
C
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
D016209:Interleukin-8; D015926:Complement C3a; D015936:Complement C5a; D019272:Leukocyte Elastase