[Treatment of vasculitis without antineutrophil cytoplasmic autoantibodies].
RENAL INVOLVEMENT: Several types of vascularides without antineutrophil cytoplasmic autoantibodies (ANCA) can affect the kidney. The most frequently encountered are small-vessel vascularides leading to glomerulonephritis: Goodpasture's disease, lupus, and, most importantly, rheumatoid purpura and type II mixed cryoglobulinemia secondary to hepatitis C. Medium-sized vessel vascularitis, such as occurs in polyarthritis nodosa, is exceptional and leads to renal ischemia. Renal involvement in large-vessel vascularities is also exceptional, e.g. temporal artery arteritis and Takayasu's syndrome.


METHODS
Treatment must be adapted to the type of vascularides and also its class (small, medium, or large-vessel disease) and depends on the gravity of each individual patient's situation. A large range of treatments have been proposed, but there is little solid evidence concerning efficacy.
Esnault
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VL
Service de Néphrologie-Immunologie clinique, Hôtel-Dieu, 30, bd Jean Monnet, F44093 Nantes. vesnault@nantes.inserm.fr
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007511:Ischemia / Q000503:physiopathology / Q000628:therapy; D007674:Kidney Diseases / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016030:Kidney Transplantation; D011379:Prognosis; D012079:Renal Circulation; D014657:Vasculitis / Q000145:classification / Q000503:physiopathology / Q000628:therapy*
D019268:Antibodies, Antineutrophil Cytoplasmic; D005938:Glucocorticoids