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[Renal failure associated with polyarteritis nodosa].

S Fujimoto1, Y Yamamoto, M Saita

  • 1First Department of Internal Medicine, Miyazaki Medical College, Japan.

Nihon Jinzo Gakkai Shi
|June 1, 1990
PubMed
Summary
This summary is machine-generated.

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Polyarteritis nodosa (PN) can cause severe kidney failure. Early diagnosis and treatment with prednisolone improved outcomes in patients with biopsy-proven PN, suggesting a better prognosis than previously thought.

Area of Science:

  • Nephrology
  • Rheumatology
  • Pathology

Background:

  • Polyarteritis nodosa (PN) is a systemic vasculitis with a high prevalence of renal involvement (approximately 70%).
  • Renal dysfunction in PN typically presents as acute or rapidly progressive renal failure.
  • The prognosis for renal involvement in PN has historically been considered very poor.

Observation:

  • This study reports on 5 patients with renal failure associated with polyarteritis nodosa.
  • Renal dysfunction manifested 2-4 weeks after initial symptoms like fever or neuromuscular issues.
  • Initial clinical diagnoses varied, including fever of unknown origin and disseminated intravascular coagulation.

Findings:

  • Kidney pathology revealed crescentic glomerulonephritis without immunoglobulin deposits, necrotizing glomerulonephritis, and inflammatory infiltrates.

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  • Two patients treated early with prednisolone, based on biopsy-proven diagnosis, showed favorable outcomes.
  • Histological findings included granulomatous lesions, tubular necrosis, and cortical necrosis, distinct from necrotizing vasculitis.

    • Implications:

    • Early diagnosis and treatment of polyarteritis nodosa, supported by histological evidence, can significantly alter the typically poor prognosis of renal involvement.
    • Prednisolone monotherapy may be an effective treatment strategy for patients with biopsy-proven PN.
    • These findings highlight the importance of prompt renal biopsy and treatment initiation in suspected cases of PN-associated kidney disease.