Lupus nefritine benzeyen klasik poliarteritis nodosa olgu sunumu

Kidney biopsy in cPAN may reveal non-specific immune-deposits and fibrinoid necrosis of arterioles mimicking lupus nephritis and microscopic polyangiitis. c-PAN should be carefully differentiated from these entities.

📌 3 Key Takeaways

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Objective & Hypothesis:Classic polyarteritis nodosa (cPAN) is a systemic necrotizing vasculitis of medium-sized muscular arteries.

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Key Findings & Data:Urine analysis showed hematuria and 1g/day proteinuria.

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Conclusion & Impact:Kidney biopsy in cPAN may reveal non-specific immune-deposits and fibrinoid necrosis of arterioles mimicking lupus nephritis and microscopic polyangiitis. c-PAN should be carefully differentiated from these entities.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

Classic polyarteritis nodosa (cPAN) is a systemic necrotizing vasculitis of medium-sized muscular arteries. Glomerular involvement is not expected in the course of cPAN. Herein, we describe a case of cPAN with glomerular and multiple arterial involvement. The patient presented with severe abdominal pain and high fever. Urine analysis showed hematuria and 1g/day proteinuria. Kidney biopsy showed fibrinoid necrosis of arterioles and IgG, IgA and C1q positivity raising a suspicion of lupus nephritis. However digital subtraction angiography revealed typical multiple micro-aneurysms in the coronary, mesenteric, splenic and renal arteries establishing the diagnosis of cPAN. Kidney biopsy in cPAN may reveal non-specific immune-deposits and fibrinoid necrosis of arterioles mimicking lupus nephritis and microscopic polyangiitis. c-PAN should be carefully differentiated from these entities.

Özet

Klasik poliarteritis nodosa (cPAN) orta boy musküler arterleri tutan sistemik nekrotizan bir vaskülittir. Klasik PANın seyrinde glomerüler tutulum genelde beklenmemektedir. Burada glomerüler ve multipl arteryal tutulumu olan bir klasik PAN olgusu tartışılacaktır. Hasta ciddi karın ağrısı ve yüksek ateş nedeni ile başvurdu. İdrar tahlilinde hematüri ve 1 gr/gün proteinüri gözlendi. Böbrek biyopsisi yapıldı ve histolojide lupus nefritini düşündüren arterioler fibrinoid nekroz ve IgG, IgA, C1q pozitifliği görüldü. Buna karşın dijital subtraksiyon anjiyografide koroner, mesenterik, splenik ve renal arterlerde tipik multipl mikroanevrizmalar görülmesi üzerine cPAN tanısı kondu. Klasik PANın böbrek biyopsisi non-spesifik immün deposit ve arterioler fibrinoid nekroz görünümü ile lupus nefritini ve mikroskopik polianjitisi taklit edebilir. Ayırıcı tanıda Klasik PAN bu antitelerden dikkatlice ayrılmalıdır.

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Cite This Article

ELÇİOĞLU, Ö. C., ODABAŞ, A. R., ÖZKÖK, A., BAKAN, A., KANBAY, M., ALIŞIR, S., ERDEMOĞLU, E., TELCİ, Ö. Ç., AYDIN, K. B. (2022). Lupus nefritine benzeyen klasik poliarteritis nodosa olgu sunumu. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, Cilt: 23 - Sayı: 2, 169–171. https://ajindex.com/articles/636287

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