Microscopic Polyangiitis

Microscopic Polyangiitis: Complications

The following are the most important diseases or complications that may be contributed to by microscopic polyangiitis (MPA): Respiratory system (J00-J99) Pulmonary syndrome – combination of renal and pulmonary vasculitis (inflammation of the (mostly) arterial blood vessels in the kidneys and lungs) including necrotizing extracapillary proliferative glomerulonephritis (inflammation of the glomeruli (renal corpuscles) of the … Microscopic Polyangiitis: Complications

Microscopic Polyangiitis: Classification

Activity stages of ANCA-associated vasculitides (AAV). Activity stage Definition Localized stage Upper and/or lower respiratory tract without systemic manifestation, without B symptoms, not organ-threatening1 Early systemic stage All organ involvement possible, not life-threatening or organ-threatening2 Generalization stage Renal involvement (kidney involvement) or other organ-threatening manifestation, creatinine < 500 µmol/l (5.6 mg/dl)3 Severe, vital-threatening generalization stage. … Microscopic Polyangiitis: Classification

Microscopic Polyangiitis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [subcutaneous nodules, palpable purpura (small-spotted capillary hemorrhages in the skin, subcutis, or mucous membranes (cutaneous hemorrhage)), possibly necrosis; lower … Microscopic Polyangiitis: Examination

Microscopic Polyangiitis: Test and Diagnosis

Laboratory parameters of 1st order – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Urinalysis Microscopy (microhematuria/excretion of blood in urine not visible to the naked eye). Proteinuria (increased excretion of protein in the urine). Autoimmune serology PANCA (perinuclear antineutrophil cytoplasmic antibody); often with the target antigen myeloperoxidase (anti-myeloperoxidase antibody/MPO-ANCA) (in … Microscopic Polyangiitis: Test and Diagnosis

Microscopic Polyangiitis: Drug Therapy

Therapeutic target Risk reduction or prevention of complications. Therapy recommendations Therapy is stage- and activity-based. Localized stage Induction therapy: methotrexate (MTX) (folic acid antagonist/immunosuppressants) and glucocorticoids (steroids). Maintenance therapy: low-dose steroids and azathioprine (purine antagonists/immunosuppressants) or leflunomide (immunosuppressants) or methotrexate. Early systemic stage Induction therapy: methotrexate or cyclophosphamide (alkylants) and glucocorticoids (steroids); in patients with … Microscopic Polyangiitis: Drug Therapy

Microscopic Polyangiitis: Diagnostic Tests

Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic clarification. Abdominal ultrasonography (ultrasound examination of the abdominal organs) – for basic diagnostics. X-ray of the thorax (X-ray thorax/chest), in two planes.

Microscopic Polyangiitis: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate microscopic polyangiitis (MPA): Renal involvement (70%) – glomerulonephritis (inflammation of the glomeruli (renal corpuscles) of the kidneys) of varying severity (rapid progressive glomerulonephritis (RPGN), focal segmental sclerosing glomerulonephritis (FSSGN)); leads to renal hypertension (high blood pressure caused by kidney disease), possibly with headache and development of renal insufficiency … Microscopic Polyangiitis: Symptoms, Complaints, Signs

Microscopic Polyangiitis: Causes

Pathogenesis (disease development) The etiology (causes) of microscopic polyangiitis (MPA) remains unclear. Genetic factors, the complement system, B- and T-cell response, cytokine involvement, and endothelial changes are thought to be important with regard to pathogenesis. Infectious triggers are also discussed as triggers. Neutrophils, B cells, and ANCA (antineutrophil cytoplasmic antibodies) are at the forefront of … Microscopic Polyangiitis: Causes

Microscopic Polyangiitis: Medical History

Medical history (history of illness) is an important component in the diagnosis of microscopic polyangiitis (MPA). Family history What is the general health of your family members? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social history What is your profession? Current medical history/systemic history … Microscopic Polyangiitis: Medical History

Microscopic Polyangiitis: Or something else? Differential Diagnosis

Musculoskeletal system and connective tissue (M00-M99). Other vasculitides (inflammatory rheumatic diseases characterized by a propensity for inflammation of (usually) arterial blood vessels) Granulomatosis with polyangiitis (GPA), formerly Wegener’s granulomatosis. Collagenoses (group of autoimmune diseases associated with changes in connective tissue) – especially Systemic Lupus Erythematosus (SLE). Polyarteritis nodosa (PAN, synonyms: Kussmaul-Maier disease, panarteritis nodosa; M30.0) … Microscopic Polyangiitis: Or something else? Differential Diagnosis