[Rapidly progressive glomerulonephritis in macroscopic periarteritis nodosa. 7 cases].
Rapidly progressive glomerulonephritis (RPGN) is rarely associated with macroscopic polyarteritis nodosa (PAN), as seen in this series of 7 out of 235 patients. The clinical symptoms of PAN were as follows: myalgias 6; fever 1; arthralgias and mononeuropathy multiplex 5; cutaneous vasculitis 3; arterial hypertension 4, 3 of which were malignant. The mean proteinuria was 2.7 g/24 h; creatininemia 458 microM/l; microscopic hematuria was present in 4 of the 7 patients; only 1 patient was anuric. Markers of hepatitis B virus were absent in all cases. Arteriography revealed microaneurysms and renal infarcts in 6 patients and distal arterial stenosis in one. Renal biopsies from all 7 patients demonstrated extracapillary glomerulonephritis, which was associated with tubulointerstitial fibrosis in one. Necrotizing vasculitis lesions were associated in 5 cases. Immunofluorescence was positive in 5 cases. The association of RPGN and PAN exists and may be underestimated due to the lack of systematic angiographic examinations during RPGN and renal biopsies in PAN patients with renal involvement.
Cevallos
R
R
Service de Médecine Interne, Université Paris-Nord, Bobigny.
Guillevin
L
L
Jarrousse
B
B
Godeau
B
B
Makdassi
R
R
Lambrey
G
G
Barrier
J
J
D000328:Adult; D000368:Aged; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000150:complications* / Q000473:pathology
Glomérulonéphrites rapidement progressives au cours de la périartérite noueuse macroscopique. Sept observations. Groupe de Traitement de la Périartérite Noueuse (Société Nationale Française de Médecine Interne).