Faculty Opinions recommendation of Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis.

2010 ◽  
Author(s):  
Cees Kallenberg
Keyword(s):  
Renal Vasculitis

scholarly journals An unusual precipitant of acute heart failure—ANCA-associated vasculitis in a patient with ischaemic cardiomyopathy: a case report

2020 ◽  
Author(s):  
Krishna Prasad ◽  
Pruthvi C Revaiah ◽  
Krishna Santosh Vemuri ◽  
Parag Barwad
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Acute Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Antineutrophil Cytoplasmic Antibody ◽  
Left Ventricular ◽  
Alveolar Haemorrhage ◽  
Coronary Syndrome ◽  
Anca Associated Vasculitis ◽  
Renal Vasculitis

Abstract Background Antineutrophil cytoplasmic antibody (ANCA)-associated pulmonary renal vasculitis is an uncommon disease entity. Its presentation as acute heart failure for the first time in a patient with established coronary artery disease (CAD) is even rarer. We present here a case of such an association and an approach to managing this clinical situation. Case summary A 60-year-old male patient presented to the emergency room with recent-onset dyspnoea New York Heart Association Class IV. He was having hypertension, uncontrolled diabetes mellitus, chronic kidney disease (CKD), and CAD. He also underwent a percutaneous coronary intervention to left anterior descending in the past for acute coronary syndrome and had moderate left ventricular dysfunction. He was being managed as a case of acute decompensated heart failure (ADHF) and was mechanically ventilated. Suddenly his ventilator requirement increased and endotracheal aspirate contained blood. The chest radiograph showed bilateral hilar infiltrates. Simultaneously he also had recurrent episodes of ventricular tachycardia (VT) requiring direct current (DC) cardioversion. Blood investigations showed deranged renal function and severe hyperkalaemia, but no evidence of coagulopathy. High-resolution computed tomography chest showed features of diffuse alveolar haemorrhage. Further investigations revealed high titres of c-ANCA and raised inflammatory biomarkers. A diagnosis of ANCA-associated vasculitis presenting as acute on CKD with dyselectrolytaemia (hyperkalaemia) leading to VT was made. Apart from standard management for associated illness, he was treated with plasma exchange, steroids, and cyclophosphamide to which he responded and was later on discharged. Discussion Antineutrophil cytoplasmic antibody-related pulmonary renal vasculitis can lead to rapidly progressing renal failure and may present as ADHF in a patient with existent CAD. The associated VT storm in our patient can be attributed to hyperkalaemia secondary to acute renal failure. A multidisciplinary approach is required for the successful management of such a complex clinical scenario.

scholarly journals Urine IgM excretion predicts outcome in ANCA-associated renal vasculitis

2006 ◽  
Vol 21 (5) ◽  
pp. 1263-1269 ◽  
Author(s):  
Omran Bakoush ◽  
Mårten Segelmark ◽  
Ole Torffvit ◽  
Sophie Ohlsson ◽  
Jan Tencer
Keyword(s):  
Renal Vasculitis

scholarly journals Giant cell arteritis presenting as renal vasculitis.

1998 ◽  
Vol 74 (869) ◽  
pp. 170-171 ◽  
Author(s):  
Y. K. Govil ◽  
K. Sabanathan ◽  
D. Scott
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Renal Vasculitis

Renal Vasculitis

2001 ◽  
Author(s):  
Kevin Davies ◽  
Sozos Loizou ◽  
Michael Samarkos
Keyword(s):  
Renal Vasculitis

scholarly journals Outcomes of hydralazine induced renal vasculitis

2018 ◽  
Vol 5 (1) ◽  
pp. 5-8 ◽  
Author(s):  
Homa Timlin ◽  
Jason E. Liebowitz ◽  
Khusleen Jaggi ◽  
Duvuru Geetha
Keyword(s):  
Renal Vasculitis

scholarly journals Use of mycophenolate in ANCA-associated renal vasculitis: 13 years of experience at a university hospital

2015 ◽  
Vol 30 (suppl_1) ◽  
pp. i132-i137 ◽  
Author(s):  
J. Draibe ◽  
R. Poveda ◽  
X. Fulladosa ◽  
A. Vidaller ◽  
C. Zulberti ◽  
...  
Keyword(s):  
University Hospital ◽  
Years Of Experience ◽  
Renal Vasculitis

The Clinical Application of Urine Soluble CD163 in ANCA-Associated Vasculitis

2021 ◽  
pp. ASN.2021030382
Author(s):  
Sarah Moran ◽  
Jennifer Scott ◽  
Michael Clarkson ◽  
Niall Conlon ◽  
Jean Dunne ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Kidney Injury ◽  
Urine Protein ◽  
Prospective Multicenter Study ◽  
Soluble Cd163 ◽  
Anca Associated Vasculitis ◽  
Renal Vasculitis ◽  
Total Urine ◽  
Nephrotic Range Proteinuria ◽  
Positive Results

Background Up to 70% of patients with ANCA-associated vasculitis (AAV) develop glomerulonephritis, with 26% progressing to ESKD. Diagnostic-grade and noninvasive tools to detect active renal inflammation are needed. Urinary soluble CD163 (sCD163) is a promising biomarker of active renal vasculitis, but a diagnostic-grade assay, assessment of its utility in prospective diagnosis of renal vasculitis flares, and evaluation of its utility in proteinuric states are needed. Methods We assessed a diagnostic-grade urinary sCD163 assay in (1) a real-world cohort of 405 patients with AAV and 121 healthy and 488 non-AAV disease controls; (2) a prospective multicenter study of 84 patients with potential renal vasculitis flare; (3) a longitudinal multicenter cohort of 65 patients with podocytopathy; and (4) a cohort of 29 patients with AAV (with or without proteinuria) and 10 controls. Results We established a diagnostic reference range, with a cutoff of 250 ng/mmol for active renal vasculitis (area under the curve [AUC], 0.978). Using this cutoff, urinary sCD163 was elevated in renal vasculitis flare (AUC, 0.95) but remained low in flare mimics, such as nonvasculitic acute kidney injury. Urinary sCD163's specificity declined in AAV patients with nephrotic-range proteinuria and in primary podocytopathy, with 62% of nephrotic patients displaying a "positive" urinary sCD163. In AAV patients with significant proteinuria, urinary sCD163 normalization to total urine protein rather than creatinine provided the greatest clinical utility for diagnosing active renal vasculitis. Conclusions Urinary sCD163 is elevated in renal vasculitis flare and remains low in flare mimics. Nonspecific protein leakage in nephrotic syndrome elevates urinary sCD163 in the absence of glomerular macrophage infiltration, resulting in false-positive results; this can be corrected with urine protein normalization.

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