Wary of kidney damage caused by primary vasculitis

MPA and WG mainly affects the small arteries, capillaries and small veins, often multi-organ system involvement of small blood vessels, the basic vascular wall lesions leukocyte infiltration and fibrinoid necrosis.

An MPA and WG clinical manifestations occur in the elderly, more common in men. Patients with early disease symptoms, such as fever (fever or fever), weight loss, anemia, skin purpura, muscle pain, joint pain and peripheral neuritis, etc. These symptoms of the disease, though not specific, but suggesting that the disease is very significance. Kidney most likely involved, the patient presented nephritic syndrome (both hematuria, of which 13 cases have gross hematuria, glomerular source of hematuria), yet few patients with nephrotic syndrome. Showed a progressive impairment of renal function, as well as acute renal failure. The degree of involvement of the lungs easy living Secondly, the patient cough, hemoptysis, and shortness of breath, light only blood stained sputum, severe hemoptysis even suffocation. Chest X-ray examination, MPA showed a lobular pneumonia-like shadow shadow or extensive alveolar hemorrhage (dense fine powdered shadow to both sides by hilar lung expansion was a butterfly, the upper and lower lung fields clear), while WG was mainly limitations or cavity necrotizing pneumonia (one to several round or oval thin-walled hollow). WG addition to involving the lower respiratory tract, but also often violated due to sinusitis and other upper respiratory tract. In addition to kidney and lung, other organ systems such as the central nervous system (cerebral infarction, cerebral hemorrhage), heart (myocardial infarction), digestive (abdominal pain, bleeding, pancreatitis and cholecystitis) and reproductive systems (testicular inflammation) may also be involved, and the eye (keratitis, scleritis, uveitis and retinopathy), ear (nerve deafness) lesions are not uncommon.
Two pathological changes MPA and WG mainly affects the small arteries, capillaries and small veins, often multi-organ system involvement of small blood vessels, the basic vascular wall lesions leukocyte infiltration and fibrinoid necrosis. WG can still see the characteristic lesions of granuloma in perivascular (by a large number of mononuclear cells, multinucleated giant cells, epithelial cells and fibroblasts form). When renal involvement, light microscopy examination showed glomerular fibrinoid necrosis and (or) crescent formation, WG patients also found in renal interstitial granulomas. Small renal artery vasculitis can be presented, but also normal (it is not because of the small renal arteries normal and deny the disease). Often without the immunofluorescence glomeruli, or only trace of non-specific immune deposits (and therefore the disease is also known as "micro-immune glomerulonephritis"). SEM examination without the presence of electron-dense material.