Skip to main content

Systemic Vasculitis with Renal Involvement — A Review

Summary

Twenty five patients with renal vasculitis presenting over an eight year period were reviewed. Ten had microscopic polyarteritis, 6 classic polyarteritis, 5 overlap syndrome, 2 Churg-Strauss syndrome and 2 Wegener’s granulomatosis. Clinical features included hypertension, pulmonary involvement, neurological involvement and arthralgia. Serum creatinine was over 500 umol/1 in 13 patients, 10 of whom required dialysis. Visceral angiography was positive in 80% of those studied, Focal and segmental necrotising glomerulonephritis was the commonest renal lesion. Treatment consisted of corticosteroids and cytotoxic agents in most cases. Plasmapheresis was used for rapidly progressive renal failure, severe pulmonary haemorrhage or cerebral vasculitis. Improvement or stabilisation of renal function was seen in 68% of patients treated. There were 4 early deaths and one late death. The diagnosis, histology, treatment and outcome of renal vasculitis is discussed. The importance of early diagnosis and treatment is emphasised in this potentially reversible cause of acute renal failure.

This is a preview of subscription content, access via your institution.

References

  1. Balow, J. E. Renal Vasculitis. K. Int. 1985: 27: 954–964.

    CAS  Google Scholar 

  2. Fauci, A. S., Haynes, B.F., Katz, P. The spectrum of vasculitis. Clinical, pathologic, immunologic and therapeutic considerations Ann. Int. Med. 1978: 89: 660–676.

    CAS  Google Scholar 

  3. Kussmaul, A., Maier, K. über einebischer nicht beschreibene eigenthümliche arteri-enerkrankung (periarteritis nodosa), die mit morbus brightü und rapid fortschreitender allgemeiner Muskellahmüng einherght. Deutsches Arch Klin Med 1866: 1: 484–517.

    Google Scholar 

  4. Davson,J.,Ball, J.,Platt, R. The kidney in periarteritis nodosa. Q. J. Med. 1948: 17: 175–202.

    PubMed  CAS  Google Scholar 

  5. Leavitt, R. Y., Fauci, A. S. Polyangütis overlap syndrome. Am. J. Med. 1986; 81: 79–85

    PubMed  Article  CAS  Google Scholar 

  6. paVan der Woude, F. J:, Rasmussen, N.,Lobatto, S. et al. Auto-antibodies against neutrophils and monocytes: Tool for diagnosis and marker of diasease activity in Wegener’s granulomatosis. Lancet 1985:425–429.

  7. Lockwood, C. M., Bakes, D., Jones, S.,Whitaker,K.B.,Moss,D.W. Savage,C.O.S. Association of alkaline phosphatase with an autoantigen recognised by circulating anti-neutrophil antibodies in systemic vasculitis. Lancet 1987: i: 716–720.

    Article  Google Scholar 

  8. Lanham, J. G., Elkon, K. B., Pusey, C. D.,Hughes, G. R. Systemic Vasculitis with asthma and eosinophilia: A Clinical approach to the Churg-Strauss Syndrome. Medicine 1984: 63: 65–81.

    PubMed  Article  CAS  Google Scholar 

  9. Baker, S.B., Robinson, D.R. Unusual renal manifestations of Wegeners granulomatosis. Am. J.Med. 1978: 64: 833.

    Article  Google Scholar 

  10. Neild, G. H., Cameron, J. S., Ogg, C. S. et al. Rapidly progressive glomerulonephritis with extensive glomerular crescent formation. Q. J. Med. 1983: 207: 395–416.

    Google Scholar 

  11. Frohnert, P. P., Sheps,. S. G. Longterm follow-up study of polyarteritis nodosa. A.J.Med. 1967: 43: 8–14.

    Article  CAS  Google Scholar 

  12. Leib, E. S., Restivo, C., Paulus, H.E. Immunosuppressive and corticosteroid therapy of polyarteritis nodosa. Am. J. Med. 1979: 67: 941–947.

    PubMed  Article  CAS  Google Scholar 

  13. Fauci, A. S., Katz, P., Haynes, B. F., Wolff S. M. Cyclophosphamide therapy of severe systemic necrotizing vasculitis. N. Eng. J.Med. 1979: 301: 235–238.

    CAS  Google Scholar 

  14. Serra, A., Cameron, J. S., Turner, D. R. et al. Vasculitis affecting the kidney: Presentation, pathology and longterm outcome. Q.J.Med. 1984: 53 181–207.

    PubMed  CAS  Google Scholar 

  15. Savage, C.O.S., Winerals, C.G., Evans, D.J., Rees, A. J., Lockwood, C. M. Microscopic polyarteritis: Presentation, pathology and prognosis. Q. J. Med. 1985: 220: 467–483

    Google Scholar 

Download references

Author information

Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Cite this article

O’Meara, Y., Green, A., Carmody, M. et al. Systemic Vasculitis with Renal Involvement — A Review. I.J.M.S. 158, 300–303 (1989). https://doi.org/10.1007/BF02983692

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02983692

Keywords

  • Vasculitis
  • Systemic Vasculitis
  • Polyarteritis Nodosa
  • Henoch Schonlein Purpura
  • Fibrinoid Necrosis