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Renal Arteritis


Presentation

  • We report the first case of IgG4-related tubulointerstitial nephritis with multifocal plasma cell-rich renal arteritis presenting as acute kidney injury in a 72-year-old man.[ncbi.nlm.nih.gov]
  • Presenting demographics and disease parameters are summarized in Table 1.[acrabstracts.org]
  • She presented with fulminant and severe renal insufficiency due to crescentic glomerulonephritis.[link.springer.com]
  • We present four young patients who initially presented with hypertension due to RAS. Clinical criteria coupled with non-invasive studies in all four cases led to the diagnosis of Takayasu's arteritis. All four patients had good outcomes.[journals.lww.com]
Fever
  • A 64-year-old woman with hypertension and hyperlipidemia was admitted to our hospital for the investigation and management of general fatigue, anorexia, a 5-kg weight loss, and a 4-week history of high-grade fever.[ncbi.nlm.nih.gov]
  • Abstract A 64-year-old woman with hypertension and hyperlipidemia was admitted to our hospital for the investigation and management of general fatigue, anorexia, a 5-kg weight loss, and a 4-week history of high-grade fever.[jstage.jst.go.jp]
  • […] in malignant hypertension, severe renal impairment, cardiac decompensation and premature death. 3 Case report A sixty-five year-old female, born and living in Pelotas, a former smoker, with a previous history of mitral valve disease due to rheumatic fever[scielo.br]
Malaise
  • […] multinucleated giant cells Can produce either luminal compromise (more common) or dilatation and aneurysms Us. young women, most often Asian or European background, us. onset age 10-30y Initial presentation includes fever, arthralgias, arthritis, and malaise[faculty.washington.edu]
  • Comment: In summary, this 73 year old male with a three month history of constitutional symptoms including weight loss, night sweats, fatigue and malaise presents with rapidly progressive acute renal failure, hemoptysis and diffuse bilateral pulmonary[path.upmc.edu]
  • Constitutional symptoms may include weight loss, malaise, fever, depression, and polymyalgia rheumatica, night sweats [1] [5] [6] [10] [4] .[physio-pedia.com]
  • Takayasu's arteritis affects the thoracic and abdominal aorta and its main branches or the pulmonary arteries. 17 It primarily affects young women, particularly of Asian descent, and may be manifested by malaise, arthralgias and the gradual onset of extremity[aafp.org]
  • Systemic symptoms occur to 20-80% of patients and are characterized by fatigue, malaise, weight loss, arthralgias, and myalgias.[rheumatologyadvisor.com]
Rapidly Progressive Glomerulonephritis
  • Contributor's Note: Crescentic glomerulonephritis or rapidly progressive glomerulonephritis (RPGN) is a term given to a diverse group of diseases which all have cresents present within the glomerular tuft (Table 1).[path.upmc.edu]
  • Renal involvement may present as a rapidly progressive glomerulonephritis(GN) with renal biopsy showing a pauci-immune crescentic GN.[rarerenal.org]
  • The typical presentation of renal vasculitis is that of a rapidly progressive glomerulonephritis.[cjasn.asnjournals.org]
Euthyroid
  • […] reverse flow of the vertebral artery. 14 In our case, we associated the partial improvement of the symptoms with the early hypothyroidism - the subclavian steal syndrome, as the patient remained with dizziness and slowness of thought even after a state of euthyroidism[scielo.br]
Hypertension
  • However, an important differential for hypertension in the young Asian population is Takayasu's arteritis. We present four young patients who initially presented with hypertension due to RAS.[journals.lww.com]
  • Among the 13 with hypertension including two who developed hypertension over the follow-up period; 11 were on anti-hypertensive drugs. Among the six patients with renal asymmetry ; five were known and one developed this over the follow-up period.[acrabstracts.org]
  • Presentation Young hypertensive woman, referred for evaluation of hypertension. She clinically had features of pulseless disease. Patient Data Age: 27 yrs Gender: Female Loading images...[radiopaedia.org]
  • The outcome of hypertension was defined as follows: (1) cured (normotensive off anti-hypertensives), (2) improved (normotensive on same or reduced number of medications), or (3) failure (no cure or improvement in number of medications).[link.springer.com]
  • A 64-year-old woman with hypertension and hyperlipidemia was admitted to our hospital for the investigation and management of general fatigue, anorexia, a 5-kg weight loss, and a 4-week history of high-grade fever.[ncbi.nlm.nih.gov]
Vascular Disease
  • What is renal vascular disease? Renal vascular disease is the name given to a variety of complications that affect the arteries and veins of the kidneys.[unmc.edu]
  • .- ) Diseases of the circulatory system I77 ICD-10-CM Diagnosis Code I77 Other disorders of arteries and arterioles 2016 2017 2018 2019 Non-Billable/Non-Specific Code Type 2 Excludes collagen (vascular) diseases ( M30-M36 ) hypersensitivity angiitis ([icd10data.com]
  • Renal vascular diseases are usually the manifestation of a systemic vascular disease. Here we will focus on renal changes in vascular diseases, and not on extrarenal involvement.[kidneypathology.com]
  • A 2008 study assessing quality of life with Takayasu arteritis showed worse scores for physical and mental health compared with many other chronic diseases associated with peripheral vascular disease.[emedicine.medscape.com]
Tachycardia
  • The patient's workup showed a pulse rate of 104 beats/min, cardiomegaly and signs of cephalization on chest X-ray [Figure 1] , and sinus tachycardia on electrocardiography.[rcvmonline.com]
  • She continued under medical care at a basic healthcare unit in her own district, where she used to present nonspecific symptoms such as fatigue, diffuse arthralgia, dizziness, intermittent claudication, diffuse myalgia, tachycardia, and depressive symptoms[scielo.br]
Oliguria
  • In one of these visits, she complained of recent oliguria, slowness, drowsiness and hair loss. Her laboratory tests showed TSH 66.09 mIU/L; free T 4 of 0.53 ng/dL; creatinine of 5.58 mg/dL and urea of 172 mg/dL.[scielo.br]
  • STEC-HUS : This form, also called the classical form, presents after or during an episode of diarrheal disease, there is acute renal failure with oliguria, proteinuria, hematuria, anemia and thrombocytopenia.[kidneypathology.com]

Workup

  • Progress logically from the histologic pattern, through the appropriate workup, around the pitfalls, to the best diagnosis.[books.google.es]
  • Serological workup revealed a high-titre perinuclear antinuclear cytoplasmic antibody and antibodies to myeloperoxidase. Renal biopsy demonstrated a pauci-immune focal crescentic glomerulonephritis.[casereports.bmj.com]
  • Initial workup revealed BUN 62mg/dl, creatinine 2.8mg/dl, random urine protein 76mg/dl with 24-hour urine protein 576mg but no urine RBCs, ESR 81mm/hr, CRP 170mg/l, total CPK 245u/l, and positive MPO-ANCA with titer 8.[shmabstracts.com]
  • The patient's workup showed a pulse rate of 104 beats/min, cardiomegaly and signs of cephalization on chest X-ray [Figure 1] , and sinus tachycardia on electrocardiography.[rcvmonline.com]
  • Angiography-based categories Takayasu arteritis can be divided into the following six types based on angiographic involvement (see Workup ) [3] : Type I - Branches of the aortic arch Type IIa - Ascending aorta, aortic arch, and its branches Type IIb -[emedicine.medscape.com]
Small Kidney

Treatment

  • Diagnosis and surgical treatment of a Takayasu disease on an abdominal aortic dissection. Ann Vasc Surg 2011; 25: 556.e1-5. Ando M, Okita Y, Tagusari O, Kitamura S, Matsuo H.[termedia.pl]
  • The condition drastically improved after treatment with 30 mg/day of oral prednisolone.[ncbi.nlm.nih.gov]
  • She was started on a drug treatment for vasculitis with deflazacort at 30 mg/day.[scielo.br]
  • She was started on a drug treatment for vasculitis with deflazacort at 30 mg/day. Figure 1.[bjn.org.br]

Prognosis

  • Our results suggest renal prognosis is better than previously thought. Disclosure: C. Baldwin , None; A. Mohammad , None; D. Jayne , None. « Back to 2014 ACR/ARHP Annual Meeting ACR Meeting Abstracts -[acrabstracts.org]
  • […] presentation of TA, we recommend a high clinical index of suspicion of renal artery involvement and sufficient heed to its significance especially in view of the fact that its early diagnosis and timely appropriate treatment can confer a much better prognosis[rcvmonline.com]
  • Renal‐artery stenosis in a solitary kidney should be considered as a cause of anuria with an excellent prognosis when revascularization is initiated early.[academic.oup.com]
  • In addition, the prognosis of TA has improved with the available treatment modalities [ 14 Ohigashi H, Haraguchi G, Konishi M.[benthamopen.com]
  • One study suggested that a low ESR, early treatment with steroids and a stable condition at presentation were factors which predicted a good prognosis. [ 17 ][patient.info]

Etiology

  • Persistent perplexing pyrexia: some comments on etiology and diagnosis. Med Clin North Am. 1970 Mar; 54 (2):379–396. [ PubMed ] [ Google Scholar ] Barbado FJ, Vázquez JJ, Peña JM, Arnalich F, Ortiz-Vázquez J.[ncbi.nlm.nih.gov]
  • Since then, this procedure has been performed successfully several times and become the alternative treatment to the surgical approach with better results in pediatric patients. [7] To sum up, TA with renal artery involvement must be regarded as an etiologic[rcvmonline.com]
  • ABSTRACT: Takayasu arteritis is a rare disease of unknown etiology that affects the aorta and its main branches. It is a condition, geographically more common in Southeast Asia, which mainly affects women of reproductive age.[bjn.org.br]
  • The etiology and predisposing factors of TA are as yet unknown.[ped-rheum.biomedcentral.com]
  • Etiology The etiology of Takayasu arteritis is unknown.[emedicine.medscape.com]

Epidemiology

  • In this review, we present the epidemiology, clinical manifestations, diagnosis and treatment of Takayasu's arteritis with particular emphasis on renal artery stenosis.[ncbi.nlm.nih.gov]
  • Epidemiology of Takayasu arteritis. Presse Med 2017;46:e197-e203. 4. Jokar MH, Takayasu arterities in Iran. SAS J Med 2016;2:64-8. 5. Valente ES, de Almeida R, Sacco AG, Lazzarin MC, da Silva AM, Andreazza M, et al.[rcvmonline.com]
Sex distribution
Age distribution

Pathophysiology

  • Written by leading pathologists, this second edition presents an up-to-date , concise presentation of major pathological, clinical, pathophysiological, and genetic information for over 240 diagnoses .[books.google.es]
  • From basic science and pathophysiology to clinical best practices, Brenner & Rector’s The Kidney is your go-to resource for any stage of your career.[books.google.com]
  • Large artery vasculitides Takayasu's arteritis Pathophysiology Involves the aorta (us. the most severely affected vessel) and its primary branches, including renal and mesenteric aa.[faculty.washington.edu]
  • Other pathophysiologic consequences include hypotensive ischemic retinopathy, vertebrobasilar ischemia, microaneurysms, carotid stenosis, hypertensive encephalopathy, and inflammatory bowel disease.[emedicine.medscape.com]

Prevention

  • An antiplatelet agent was prescribed to prevent thrombotic complications. At 3 months after initiation of treatment, the patient remained normotensive.[ped-rheum.biomedcentral.com]
  • Appropriate local and systemic therapy has to be initiated for other organ manifestations and to prevent recurrence of the disease.[academic.oup.com]
  • In about 50% of cases, steroid treatment alone is not sufficient to prevent vasculitis progression, requiring the addition of immunosuppressive therapy. 7 The difficulty in dealing with TA is a reflection of the nature of the disease and its rarity, which[scielo.br]

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