"Polyvasculitis under the microscope" is hard to prevent, so be careful!

What is polyangiitis under the microscope

Microscopic polyangiitis is a systemic necrotizing vasculitis disease that mainly accumulates small blood vessels, often invading the small blood vessels of the kidneys, skin and lungs;

Since most patients can detect anti-neutrophil cytoplasmic antibodies, which is what we often call positive for ANCA antibodies , the disease is also attributed to ANCA-related vasculitis
.

What are the clinical manifestations of polyangiitis under the microscope?

The disease can be hyperacute onset , manifested as rapidly progressive glomerulonephritis and pulmonary hemorrhage, of course, it can also be very insidious and difficult to detect.
Skin purpura and mild kidney damage can be seen for several years
.

The typical clinical manifestations are lung-kidney-skin , which is consistent with the vascular sites often involved in the disease;

More than half of the patients have lung damage, most patients have acute onset, and the most serious lung damage is diffuse alveolar hemorrhage;

Kidney involvement is the most common clinical manifestation of this disease.
Most patients can have proteinuria, hematuria, various tubular urine, edema, and renal hypertension;

There are many cases of purple epilepsy and palpable congestive maculopapular rash.
In severe cases, gangrene and acral ischemia can be seen
.

The nervous system can occur multiple neuritis, digestive system may be expressed as digested pancreatitis and intestinal ischemia caused by the abdominal bleeding,
.

What examinations should be done for polyangiitis under the microscope?

The indicators that reflect acute inflammation such as erythrocyte sedimentation rate and c-reactive protein increase, some patients may have anemia, white blood cell and thrombocytosis;

80% of patients can be positive for ANCA antibodies, which is an important diagnostic basis for polyangiitis under the microscope and an important serum indicator for monitoring the recurrence of the disease.
The titer is usually related to the activity of vasculitis
.

Chest X-ray examination can find no characteristic pulmonary infiltrates or vesicular infiltrates in the early stage; pathological examinations are more common in kidney pathological examinations, and the pathological features are segmental fibrinoid necrosis of small blood vessels, thrombosis , and neoplasms .
Lunar body formation
.

How to treat polyangiitis under the microscope?

The treatment of the disease can be divided into three stages, namely the induction period, the maintenance remission period and the treatment of relapse
.

At the same time, gamma globulin, plasma exchange, and biological agents can also be used in the treatment plan, depending on the condition of the disease

If the disease involves the kidneys and causes renal failure, it is necessary to rely on maintenance hemodialysis or kidney transplantation , but a small number of patients still relapse after transplantation

What is the prognosis of polyangiitis under the microscope?

After treatment, 90% of patients can be improved , 75% of patients can get complete remission, and about 30% of patients relapse within 1-2 years

Therefore, in the course of treatment, patients are required to closely cooperate with clinicians to monitor the condition to achieve the purpose of remission