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[Rapidly progressive glomerulonephritis in macroscopic periarteritis nodosa. 7 cases]
R Cevallos1, L Guillevin, B Jarrousse
1Service de Médecine Interne, Université Paris-Nord, Bobigny.
Annales De Medecine Interne
|January 1, 1993
Summary
Rapidly progressive glomerulonephritis (RPGN) rarely occurs with polyarteritis nodosa (PAN). This study highlights their association, suggesting it may be underdiagnosed due to insufficient diagnostic testing.
Area of Science:
- Nephrology
- Rheumatology
- Pathology
Background:
- Polyarteritis nodosa (PAN) is a systemic vasculitis that can affect renal arteries.
- Rapidly progressive glomerulonephritis (RPGN) is a severe form of kidney injury characterized by rapid loss of kidney function.
Observation:
- This series examined 7 patients with both RPGN and PAN, a rare clinical association.
- Clinical manifestations included myalgias, arthralgias, mononeuropathy multiplex, cutaneous vasculitis, and severe arterial hypertension.
- Laboratory findings revealed significant proteinuria, elevated creatinine, and hematuria, with one patient being anuric.
Findings:
- Arteriography showed microaneurysms and renal infarcts in most patients.
- Renal biopsies confirmed extracapillary glomerulonephritis and necrotizing vasculitis lesions.
- Hepatitis B virus markers were negative in all cases.
Implications:
- The co-occurrence of RPGN and PAN is likely underestimated.
- Systematic angiographic examinations and renal biopsies are crucial for diagnosing this association.
- Early recognition and diagnosis are vital for appropriate management of patients with RPGN and PAN.