Primary small vessel inflammatory renal damage

Introduction to primary vasculitic renal damage Segmental necrotizing glomerulonephritis caused by primary vasculitis (mainly seen under microscopic polyarteritis and Wegener's granulomatosis), often associated with renal insufficiency, most patients with serum resistance Anti-neutrophilcytoplasmic autoantibodies (ANCA) were positive. More common in middle-aged and older, good autumn and winter, most patients have a precursory performance of cold or drug allergy. basic knowledge The proportion of illness: 0.001% Susceptible people: more common in middle-aged Mode of infection: non-infectious Complications: abdominal pain, hemoptysis, sinusitis, conjunctivitis, iridocyclitis, choroiditis

Causes of primary small vascular inflammatory renal damage

More common in middle-aged and older, good autumn and winter, most patients have a precursory performance of cold or drug allergy. Kidney damage with renal arteritis as the main lesion. Arteriitis (small vasculitis) can occur in all organs of the body, and the kidneys are the most susceptible organs. There are many causes of small vasculitis, 70% of which are unknown, and are primary; 30% are secondary to various diseases such as systemic lupus erythematosus, allergic purpura, rheumatoid arthritis and hepatitis B virus infection. It is secondary.

Vasculitis is common in the following diseases:

1 nodular polyarteritis. Includes classic nodular polyarteritis, allergic vasculitis and granulomatosis (Cuug-Strauss' disease) and overlapping syndromes.

2 allergic vasculitis. These include allergic purpura, serum-like reactions, and vasculitis associated with infections, tumors, and connective tissue diseases.

3 Wegener's granulomatosis.

4 giant cell arteritis. Including no pulse disease, cranial arteritis and so on.

5 other vasculitis syndrome. Including lymphomatoid granulomatosis, Behcet's disease and thromboangiitis obliterans. The clinical classification is based primarily on the size of the affected vessel and the presence or absence of granuloma formation.

Primary small vascular inflammatory renal damage prevention

There are no effective preventive measures for this disease. Early detection and early treatment are the key to prevention.

Primary small vascular inflammatory renal damage complications Complications abdominal pain hemoptysis sinusitis conjunctivitis iridocyclitis choroiditis

Frequent irregular fever, rash, joint pain, muscle pain, weight loss, abdominal pain and gastrointestinal symptoms; lung and kidney involvement, consistent with allergic asthma, hemoptysis or uncontrollable lung infection; some patients have sinus Inflammation, otitis media and ocular manifestations (conjunctivitis, granulomatous keratitis, scleral inflammation, iridocyclitis and choroiditis, etc.).

Primary small vascular inflammatory renal damage symptoms Common symptoms Abdominal pain Muscle sore low fever Joint pain fever accompanied by rash proteinuria hematuria nephrotic syndrome

First, medical history and symptoms

More common in middle-aged and older, good autumn and winter seasons, most patients have a flu-like or drug-induced prodromal performance, often irregular fever, rash, joint pain, muscle pain, weight loss, abdominal pain and gastrointestinal symptoms; lung and kidney involvement Consistent, manifested as allergic asthma, hemoptysis or uncontrollable lung infection; some patients have sinusitis, otitis media and ocular manifestations (conjunctivitis, granulomatous keratitis, scleral inflammation, iridocyclitis and choroid Inflammation, etc.; There are hematuria in the early stage of kidney involvement, about 1/3 of gross hematuria, most with proteinuria or nephrotic syndrome, hypertension is rare or light, and half of them are rapidly progressive glomerulonephritis. Timely and effective treatment, some patients may fully recover their kidney function.

Second, physical examination found

Active fever is more common, may have mild anemia, eyelid or lower extremity edema, some patients have rash or eye performance.

Examination of primary small vascular inflammatory renal damage

(1) Urine routine examination has different degrees of proteinuria, hematuria and tubular urine.

(B) Most patients with anemia, increased white blood cells, occasionally elevated eosinophils.

(3) In the acute phase, the blood sedimentation is fast, the C-reactive protein is more than normal, and the -globulin is often increased.

(4) Most ANCA-positive is an important basis for the diagnosis of primary vasculitis; ANCA can reflect the activity or recurrence of the lesion, and ANCA can be positive about 4 weeks before recurrence.

(5) Ccr often decreases to varying degrees, blood urea nitrogen, creatinine increased.

(6) Chest X-ray showed alveolar hemorrhage, lobular pneumonia or localized necrotizing necrotizing pneumonia; CT scan revealed sinus or orbital lesions; B-ultrasound showed normal or enlarged kidney size.

(7) Striving for early kidney biopsy can help diagnose the disease.

Diagnosis and diagnosis of primary small vessel inflammatory renal injury

Diagnosis can be based on medical history, clinical symptoms, and laboratory findings.

Should pay attention to the exclusion of Goodpasture syndrome, acute nephritis, systemic lupus erythematosus, allergic purpura, rheumatoid arthritis with vasculitis, cryoglobulinemia and other diseases. Comprehensive judgment can be made by combining chest X-ray, renal biopsy, ANA antibody, Simth antibody, allergen test, RF, ESR, Coomb's and the like.

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