2.Renal Amyloidosis Secondary to ANCA-Associated Vasculitis: A Case Report.
He XIN ; Ning JIAN-PING ; Xu HUI ; Xiao GONG ; Yang HUI-XIANG ; Wang WEI-YUAN ; Wu XIAO-YING ; Yin HONG-LING ; Li XIAO-ZHAO
Chinese Medical Sciences Journal 2022;37(4):359-362
Renal amyloidosis secondary to anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is extremely rare. Here, we reported a 77-year-old woman with ANCA-associated vasculitis. Renal biopsy with Masson trichrome staining showed pauci-immune crescentic glomerulonephritis, and electron microscopy showed amyloid deposition in the mesangial area. Immunofluorescence revealed kappa light chain and lambda light chain negative. Bone marrow biopsy revealed no clonal plasma cell. Finally, she was diagnosed as ANCA-associated vasculitis with secondary renal amyloid A amyloidosis.
Female
;
Humans
;
Aged
;
Glomerulonephritis/diagnosis*
;
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/pathology*
;
Antibodies, Antineutrophil Cytoplasmic
;
Kidney/pathology*
;
Amyloidosis/complications*
3.Immune vasculitis induced atherosclerosis.
Min, KANG ; Hongwei, WANG ; Weizhong, WEI
Journal of Huazhong University of Science and Technology (Medical Sciences) 2005;25(5):533-5
The relationship between immune vasculitis and atherosclerosis was studied. The experimental model of weanling rabbits for immune vasculitis was reproduced by intravenous injection of 10% bovine serum albumin. There were 6 groups: group A, 25 weanling rabbits with immune vasculitis subject to coronary arteriography; group B, 10 normal mature rabbits subject to coronary arteriography; group C, 10 weanling rabbits subject to coronary arteriography; group D, 8 weanling rabbits with vasculitis and cholesterol diet; group E, 8 weanling rabbits receiving single cholesterol diet; group F: 8 weanling rabbits receiving basic diet. Four weeks later, coronary arteriography was performed in groups A, B and C. The rabbits in groups D, E and F were sacrificed for the study of pathological changes in the coronary artery after 12 weeks. The results showed that the dilatation of coronary artery occurred in 6 rabbits of group A, but in groups B and C, no dilatation of coronary artery appeared. In comparison with group E, more severe atherosclerosis occurred in group D, showing the thickened plaque, fibrous sclerosis and atherosclerotic lesion. Percentage of plaques covering aortic intima, incidence of atherosclerosis of small coronary arteries and degree of stenosis of coronary arteries were significantly higher in group D than in group E (P < 0.01). No atherosclerosis changes were found in group F. It was concluded that in the acute phase, the serum immune vasculitis can induce the dilatation of coronary artery of some weanling rabbits, and aggravate the formation of atherosclerosis in rabbits fed with cholesterol diet. Immune vasculitis is a new risk factor of atherosclerosis and ischemic heart disease.
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/chemically induced
;
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*complications
;
Atherosclerosis/*etiology
;
Cholesterol, Dietary/*administration & dosage
;
Myocardial Ischemia/etiology
;
Random Allocation
;
Risk Factors
;
Serum Albumin, Bovine
5.Organizing Pneumonia in A Patient Double-Positive for ANCA and Anti-GBM Antibodies: A Case Report.
Fang-Yuan WANG ; Xiang-Ning YUAN ; Dan-Ni SUN ; Gong XIAO ; Cheng-Huan HU ; Zhong-Hua LIAO ; Jian-Ping NING ; Hui XU ; Jun-Tao FENG ; Hong-Ling YIN ; Xiao-Zhao LI
Chinese Medical Sciences Journal 2023;38(1):66-69
Both anti-glomerular basement membrane (GBM) disease and the anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are common causes of pulmonary-renal syndrome. Organizing pneumonia (OP), a special pattern of interstitial lung disease, is extremely rare either in AAV or anti-GBM disease. We report an old woman presented with OP on a background of co-presentation with both ANCA and anti-GBM antibodies.
Female
;
Humans
;
Antibodies, Antineutrophil Cytoplasmic
;
Organizing Pneumonia
;
Autoantibodies
;
Glomerulonephritis
;
Anti-Glomerular Basement Membrane Disease
;
Pneumonia
;
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications*
6.High levels of platelet-to-lymphocyte ratio may predict reduced risk of end stage of renal disease in Chinese patients with MPO-ANCA associated vasculitis.
Li HUANG ; Chanjuan SHEN ; Yong ZHONG ; Joshua D OOI ; Peter J EGGENHUIZEN ; Ya'ou ZHOU ; Jinbiao CHEN ; Ting WU ; Ting MENG ; Zhou XIAO ; Wei LIN ; Rong TANG ; Xiang AO ; Xiangcheng XIAO ; Qiaoling ZHOU ; Ping XIAO
Journal of Central South University(Medical Sciences) 2022;47(2):211-218
OBJECTIVES:
Platelet-to-lymphocyte ratio (PLR) has recently been investigated as a new inflammatory marker in many inflammatory diseases, including systemic lupus erythematosus and immunoglobulin A vasculitis. However, there were very few reports regarding the clinical role of PLR in patients with anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. This study was thus undertaken to investigate the relationship between inflammatory response and disease activity in Chinese patients with myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) associated vasculitis. Furthermore, we evaluated whether PLR predicts the progression of end stage of renal disease (ESRD) and all-cause mortality.
METHODS:
The clinical, laboratory and pathological data, and the outcomes of MPO-ANCA associated vasculitis patients were collected. The Spearman correlation coefficient was computed to examine the association between 2 continuous variables. Cox regression analysis was used to estimate the association between PLR and ESRD or all-cause mortality.
RESULTS:
A total of 190 consecutive patients with MPO-ANCA associated vasculitis were included in this study. Baseline PLR was positively correlated with CRP (r=0.333, P<0.001) and ESR (r=0.218, P=0.003). PLR had no obvious correlation with Birmingham Vasculitis Activity Score (BVAS). Patients having PLR≥330 exhibited better cumulative renal survival rates than those having PLR<330 (P=0.017). However, there was no significant difference in the cumulative patient survival rates between patients with PLR≥330 and those with PLR<330 at diagnosis (P>0.05). In multivariate analysis, PLR is associated with the decreased risk of ESRD (P=0.038, HR=0.518, 95% CI 0.278 to 0.963). We did not find an association between PLR with all-cause mortality using multivariate analysis (HR=1.081, 95% CI 0.591 to 1.976, P=0.801).
CONCLUSIONS
PLR is positively correlated with CRP and ESR. Furthermore, PLR may independently predict the risk of ESRD.
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis*
;
Antibodies, Antineutrophil Cytoplasmic/analysis*
;
China/epidemiology*
;
Humans
;
Kidney Failure, Chronic/complications*
;
Lymphocytes
;
Peroxidase
;
Retrospective Studies
7.Co-existing proteinase 3-antineutrophil cytoplasmic antibody-associated vasculitis with immunoglobulin A nephropathy.
Adem KUCUK ; Yalcin SOLAK ; Abduzhappar GAIPOV ; Sinan BAGCACI ; Hasan ESEN ; Suleyman TURK ; Recep TUNC
The Korean Journal of Internal Medicine 2016;31(1):194-196
No abstract available.
Adult
;
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*complications/diagnosis/drug therapy/immunology
;
Antibodies, Antineutrophil Cytoplasmic/*blood
;
Biomarkers/blood
;
Biopsy
;
Drug Therapy, Combination
;
Fluorescent Antibody Technique
;
Glomerulonephritis, IGA/*complications/diagnosis/drug therapy/immunology
;
Humans
;
Immunosuppressive Agents/therapeutic use
;
Male
;
Myeloblastin/*immunology
;
Treatment Outcome
8.Retrospective clinical features and renal pathological analysis of 15 children with anti-neutrophil cytoplasmic antibody-associated vasculitis.
Na GUAN ; Yong YAO ; Ji-Yun YANG ; Hui-Jie XIAO ; Jie DING
Chinese Journal of Pediatrics 2013;51(4):283-287
OBJECTIVEAnti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a disorder with poor prognosis. This study aimed to improve the diagnosis and treatment of ANCA associated vasculitis of children, to analyze the clinical features, pathological characteristics and the prognosis of children with ANCA-associated vasculitis.
METHODFifteen children with ANCA associated vasculitis who were hospitalized from 2003 to 2012 in our hospital were included. Their data of pre-diagnosis status, clinical manifestations, renal pathology, treatment and prognosis were reviewed retrospectively.
RESULTOf the 15 children, 11 were girls and 4 boys with a mean age of 10.7 years. Fourteen children were categorized as microscopic polyangitis. The time to diagnosis varied from 0.5 month to 40 months. Hematuria and proteinuria were revealed by urine analysis in all of them, only 6 children complained with gross hematuria or edema of oliguria. Decreased glomerular filtration rate was revealed in 13 children, 8 of whom had a creatinine clearance rate of less than 15 ml/(min·1.73 m(2)). Twelve children underwent renal biopsy, crescent formation was found in 11 children. Most of the crescents were cellular fibrous crescents or fibrous crescents. Six children were diagnosed as crescentic nephritis; the process of rapidly progressive nephritis was only observed in 2 children. Segmental glomerulosclerosis or global glomerulosclerosis were found in 10 children, 3 of them were diagnosed as sclerotic glomerulonephritis. Anemia and pulmonary injury were the most common extra renal manifestations. Other extra renal manifestations included rash, pain joint, gastrointestinal symptoms, abnormal findings of cardiac ultrasonography and headache. Eight children were treated with steroid combined with cyclophosphamide, 4 were treated with steroid and mycophenolate mofetil, 2 were treated with steroid, cyclophosphamide and mycophenolate mofetil, 3 children were treated with plasma exchange. Fourteen children were followed up for 0.5 month to 4 years. The renal function did not recover in children with creatinine clearance rate of less than 30 ml/(min·1.73 m(2)), who showed crescentic glomerulonephritis or sclerotic glomerulonephritis. The children who had creatinine clearance rate of more than 30 ml/(min·1.73 m(2))had better prognosis.
CONCLUSIONMore attention should be paid to ANCA-associated vasculitis among school age girls with anemia or pulmonary diseases. The renal damage was serious in children; however, the clinical manifestations were not obvious. Children with a creatinine clearance rate of less than 30 ml/(min·1.73 m(2)) had poor prognosis. Early accurate diagnosis is very important.
Adolescent ; Anemia ; etiology ; pathology ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; complications ; diagnosis ; pathology ; Antibodies, Antineutrophil Cytoplasmic ; blood ; immunology ; Biopsy ; Child ; Child, Preschool ; Creatinine ; blood ; Female ; Glomerulonephritis ; pathology ; Hematuria ; etiology ; pathology ; Humans ; Kidney ; pathology ; physiopathology ; Kidney Function Tests ; Male ; Nephritis ; diagnosis ; etiology ; pathology ; Prognosis ; Proteinuria ; etiology ; pathology ; Retrospective Studies