[Treatment of vasculitis without antineutrophil cytoplasmic autoantibodies]

RENAL INVOLVEMENT: Several types of vascularides without antineutrophil cytoplasmic autoantibodies (ANCA) can affect the kidney. The most frequently encountered are small-vessel vascularides leading to glomerulonephritis: Goodpasture's disease, lupus, and, most importantly, rheumatoid purpura and type II mixed cryoglobulinemia secondary to hepatitis C. Medium-sized vessel vascularitis, such as occurs in polyarthritis nodosa, is exceptional and leads to renal ischemia. Renal involvement in large-vessel vascularities is also exceptional, e.g. temporal artery arteritis and Takayasu's syndrome.

Treatment must be adapted to the type of vascularides and also its class (small, medium, or large-vessel disease) and depends on the gravity of each individual patient's situation. A large range of treatments have been proposed, but there is little solid evidence concerning efficacy.