Vasculitis Asociada a Anticuerpos Citoplasmáticos Antinucleares

Descripción General

Definición

La vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus asociada a anticuerpos anticitoplasma de neutrófilos ( ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) se caracteriza por una vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus necrosante de pequeños vasos y una prueba ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis positiva sin depósitos significativos de inmunocomplejos.

Antecedentes

Los LOS Neisseria anticuerpos anticitoplasma de neutrófilos ( ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis) son:

• Autoanticuerpos dirigidos contra proteínas contenidas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el interior de los LOS Neisseria neutrófilos (y monocitos, en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum menor grado).
• Son específicos de proteínas asociadas a los LOS Neisseria gránulos citoplasmáticos de los LOS Neisseria neutrófilos y, al AL Amyloidosis unirse, desencadenan una respuesta inflamatoria exagerada (i.e., una reacción autoinmune).

Existen 2 subtipos de ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis clínicamente significativos:

• Autoanticuerpos anti-mieloperoxidasa ( MPO MPO Acute Myeloid Leukemia):
  • También conocidos como pANCA
  • Tienen una carga neta positiva
  • Se unen a la mieloperoxidasa (hay autoanticuerpos pANCA clínicamente menos significativos que se dirigen contra la elastasa, la catepsina G, la lisozima y la lactoferrina).
    • La mieloperoxidasa es una proteína que se encuentra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria gránulos de los LOS Neisseria neutrófilos y que participa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la formación de especies reactivas de oxígeno con fines antimicrobianos.
    • La deficiencia de mieloperoxidasa (secundaria a la destrucción autoinmune de neutrófilos) provoca una respuesta inflamatoria exagerada.
  • La “p” de pANCA significa perinuclear porque en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la tinción, estos anticuerpos tiñen la zona perinuclear del neutrófilo (donde la mieloperoxidasa y otras proteínas con carga negativa están muy concentradas).
• Autoanticuerpos antiproteinasa 3 (PR3):
  • También conocidos como cANCA
  • Tienen una carga neta negativa
  • Se unen a PR3
    • La PR3 es una proteína que se encuentra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria gránulos azurófilos de los LOS Neisseria neutrófilos y que participa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la proteólisis de péptidos antimicrobianos con fines antimicrobianos.
    • La deficiencia de PR3 (secundaria a la destrucción autoinmune de neutrófilos) provoca una respuesta inflamatoria exagerada.
  • La “c” de cANCA significa citoplasmático porque, en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la tinción, estos anticuerpos tiñen la zona citoplasmática periférica del neutrófilo (donde el PR3, que tiene carga positiva, está muy concentrado).

La presencia de ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis (i.e., una prueba ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis positiva):

• No:
  • Diagnostica una enfermedad
  • Se correlaciona con la severidad de los LOS Neisseria síntomas
  • Se correlaciona con la gravedad de los LOS Neisseria síntomas
• Es simplemente un marcador que ayuda a establecer patrones de enfermedad

La positividad de ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis se asocia a procesos de enfermedades autoinmunes (las siguientes designaciones pANCA/cANCA son solo orientativas; existe una variabilidad significativa):

• Vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus:
  • Granulomatosis con poliangeítis (cANCA)
  • Poliangeítis microscópica (pANCA)
  • Granulomatosis eosinofílica con poliangeítis (pANCA)
  • Glomerulonefritis necrotizante crescéntrica primaria pauciinmune (también conocida como glomerulonefritis rápidamente progresiva [ RPGN RPGN Rapidly progressive glomerulonephritis (RPGN) is a syndrome of severe glomerular disease with progressive loss of kidney function within weeks to months. Histologically, crescents (the proliferation of epithelial cells and the infiltration of monocytes/macrophages in the Bowman space) are found in the glomeruli and arise from immunologic injury. Rapidly Progressive Glomerulonephritis] o vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus renal limitada) (pANCA)
  • Vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus asociada a ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis inducida por fármacos (pANCA)
• Enfermedad por autoanticuerpos anti-membrana basal glomerular (MBG) (pANCA)
• Nefritis intersticial (pANCA)
• Colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa (pANCA)
• Colangitis esclerosante primaria (pANCA)
• Hepatitis autoinmune (pANCA)
• Artritis reumatoide (pANCA)
• Fibrosis Fibrosis Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. Bronchiolitis Obliterans quística (pANCA)

Presentación Clínica

La vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus asociada a ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis se presenta con una amplia gama de signos y síntomas dependiendo del sistema o sistemas de órganos implicados.

Síntomas constitucionales

Los LOS Neisseria síntomas constitucionales pueden estar presentes semanas o meses antes de que se desarrollen las características clínicas específicas:

• Artralgias
• Fiebre, sudores nocturnos
• Fatiga, letargo
• Pérdida de apetito
• Pérdida de peso

Afectación de las vías respiratorias superiores

• Más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la granulomatosis con poliangeitis (95%) que en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la poliangeitis microscópica (35%)
• Las manifestaciones incluyen:
  • Sinusitis Sinusitis Sinusitis refers to inflammation of the mucosal lining of the paranasal sinuses. The condition usually occurs concurrently with inflammation of the nasal mucosa (rhinitis), a condition known as rhinosinusitis. Acute sinusitis is due to an upper respiratory infection caused by a viral, bacterial, or fungal agent. Sinusitis
  • Otitis media
  • Secreción nasal purulenta/sanguinolenta
  • Úlceras en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las membranas mucosas
  • Policondritis
  • Destrucción del hueso/cartílago:
    • Pérdida de dientes
    • Deformación de la nariz en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum silla de montar
    • Pérdida de audición conductiva o deformación de la nariz en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de silla de montar (típica de la granulomatosis con poliangeitis)
  • Vía aérea:
    • Disfonía
    • Estridor
    • Tos TOS Thoracic outlet syndrome (TOS) is a broad term used for a spectrum of syndromes related to the general region of the thoracic outlet, which involves the compression or irritation of elements of the brachial plexus, subclavian artery, or subclavian vein. Thoracic Outlet Syndrome
    • Disnea
    • Roncus
    • Sibilancias
    • Hemoptisis

Afectación de las vías respiratorias inferiores

• Parénquima:
  • Crepitantes
  • Hemorragia alveolar difusa
  • Signos de consolidación y/o derrame pleural, incluyendo matidez a la percusión
• Los LOS Neisseria antecedentes de asma ASMA Autoimmune Hepatitis sugieren granulomatosis eosinofílica con poliangeitis más que granulomatosis con poliangeitis o poliangeitis microscópica.

Afectación renal

• La glomerulonefritis se observa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el 20% de los LOS Neisseria individuos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el momento del diagnóstico y en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el 80% de los LOS Neisseria individuos después de 2 años.
• Las manifestaciones incluyen:
  • Hematuria Hematuria Presence of blood in the urine. Renal Cell Carcinoma
  • Cilindros celulares
  • Hipertensión
  • ↑ Creatinina
• Glomerulonefritis rápidamente progresiva: función renal que ↓ rápidamente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum días o semanas y formación de semilunas glomerulares en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la histología

Manifestaciones cutáneas

• Afecta al AL Amyloidosis 50% de los LOS Neisseria individuos
• Se observa más comúnmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis asociada a medicamentos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum comparación con otras formas de vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus asociada a ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis
• Incluye:
  • Púrpura
  • Ulceraciones
  • Urticaria Urticaria Urticaria is raised, well-circumscribed areas (wheals) of edema (swelling) and erythema (redness) involving the dermis and epidermis with associated pruritus (itch). Urticaria is not a single disease but rather is a reaction pattern representing cutaneous mast cell degranulation. Urticaria (Hives)
  • Livedo reticularis Livedo reticularis A condition characterized by a reticular or fishnet pattern on the skin of lower extremities and other parts of the body. This red and blue pattern is due to deoxygenated blood in unstable dermal blood vessels. The condition is intensified by cold exposure and relieved by rewarming. Chronic Kidney Disease
  • Nódulos

Manifestaciones oftálmicas

• Dolor Dolor Inflammation
• Visión borrosa/diplopía
• Conjuntivitis
• Episcleritis/escleritis
• Ulceración corneal, uveítis, retinitis
• Neuropatía óptica

Manifestaciones neurológicas

• Mononeuritis múltiple (neuropatía periférica multifocal Multifocal Retinoblastoma)
• Déficits sensoriales
• Anomalías de los LOS Neisseria pares craneales
• Pérdida auditiva neurosensorial
• Meningismo

Cardiopatías

• Pericarditis Pericarditis Pericarditis is an inflammation of the pericardium, often with fluid accumulation. It can be caused by infection (often viral), myocardial infarction, drugs, malignancies, metabolic disorders, autoimmune disorders, or trauma. Acute, subacute, and chronic forms exist. Pericarditis
• Miocarditis
• Alteraciones de la conducción

Otros órganos (raras)

• Afectación del tracto gastrointestinal
• Artritis
• Enfermedad tiroidea o paratiroidea

Diagnóstico

Laboratorios

• Química sérica:
  • ↑ Creatinina indica afectación renal.
  • ↓ Albúmina indica pérdidas proteicas renales.
  • ↑ AST AST Enzymes of the transferase class that catalyze the conversion of l-aspartate and 2-ketoglutarate to oxaloacetate and l-glutamate. Liver Function Tests/ ALT ALT An enzyme that catalyzes the conversion of l-alanine and 2-oxoglutarate to pyruvate and l-glutamate. Liver Function Tests indica afectación hepática.
  • Posible alteración electrolítica debida a disfunción renal.
  • Posible alteración ácido-base debida a disfunción renal.
• Análisis de orina:
  • Proteinuria Proteinuria The presence of proteins in the urine, an indicator of kidney diseases. Nephrotic Syndrome in Children debida a daño glomerular
  • Hematuria Hematuria Presence of blood in the urine. Renal Cell Carcinoma debida a daño glomerular
• Marcadores inflamatorios:
  • Elevación inespecífica de la velocidad de eritrosedimentación (VES) y proteína C reactiva ( PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR))
  • ↑ IgE IgE An immunoglobulin associated with mast cells. Overexpression has been associated with allergic hypersensitivity. Immunoglobulins: Types and Functions (Granulomatosis eosinofílica con poliangeitis)
• Hemograma:
  • Leucocitosis
  • Trombocitosis
  • Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types normocítica normocrómica
  • Eosinofilia (Granulomatosis eosinofílica con poliangeitis)
• Inmunofluorescencia y/o ensayo inmunoabsorbente ligado a enzimas ( ELISA ELISA An immunoassay utilizing an antibody labeled with an enzyme marker such as horseradish peroxidase. While either the enzyme or the antibody is bound to an immunosorbent substrate, they both retain their biologic activity; the change in enzyme activity as a result of the enzyme-antibody-antigen reaction is proportional to the concentration of the antigen and can be measured spectrophotometrically or with the naked eye. Many variations of the method have been developed. St. Louis Encephalitis Virus) positivo para ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis (suero):
  • Proteinasa 3 (PR3)- ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis ( c-ANCA c-ANCA Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis): más comúnmente asociado con granulomatosis con poliangeitis
  • Mieloperoxidasa ( MPO MPO Acute Myeloid Leukemia)- ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis ( p-ANCA p-ANCA Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis): más comúnmente asociado con poliangeitis microscópica, granulomatosis eosinofílica con poliangeitis.

Imagenología

Los LOS Neisseria hallazgos de la radiografía de tórax y la TC pueden incluir:

• Consolidación
• Nódulos
• Derrame pleural
• Infiltrados fugaces
• Adenopatías hiliares

Criterios diagnósticos
El diagnóstico de la granulomatosis eosinofílica con poliangeitis del Colegio Americano de Reumatología incluye 4 de los LOS Neisseria 6 criterios siguientes con una especificidad de casi el 100%:

• Asma ASMA Autoimmune Hepatitis
• > 10% de eosinófilos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hemograma con diferencial
• Mononeuropatía (e.g., pie caído) o polineuropatía
• Infiltrados pulmonares fugaces
• Anomalía de los LOS Neisseria senos paranasales
• Acumulación extravascular de eosinófilos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la biopsia

Biopsia

La confirmación del diagnóstico incluye la biopsia de los LOS Neisseria órganos afectados:

• La sospecha diagnóstica puede confirmarse con una biopsia de pulmón, piel o nervio periférico (puede mostrar granulomas Granulomas A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. Sarcoidosis).
• Sitios de biopsia y hallazgos:
  • Granulomatosis con poliangeitis: La biopsia de tejido de un lugar de la enfermedad activa muestra una glomerulonefritis segmentaria, necrotizante y semilunar con escasa o nula deposición de inmunoglobulina o complemento (pauciinmune); las biopsias renales y pulmonares son las más específicas.
  • Poliangeitis microscópica: La biopsia pulmonar y/o renal (glomerulonefritis semilunar) muestra una arteritis necrotizante (histológicamente idéntica a la poliarteritis nodosa).
  • Granulomatosis eosinofílica con poliangeitis: La biopsia pulmonar muestra eosinofilia y pequeños granulomas Granulomas A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. Sarcoidosis eosinofílicos necrotizantes con vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus necrotizante que afecta a pequeñas arterias y vénulas.
  • Enfermedad por autoanticuerpos anti-membrana basal glomerular: La biopsia renal muestra glomerulonefritis necrotizante con escasa o nula deposición de inmunocomplejos o de complemento.
  • Vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus asociada a ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis inducida por fármacos: No hay hallazgos patológicos distintivos para discriminar entre vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus inducida por fármacos y otras vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus.

Tratamiento

Todos los LOS Neisseria individuos con un diagnóstico confirmado de vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus asociada a ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis requieren un tratamiento inmunosupresor. La terapia puede iniciarse tempranamente sobre la base de un diagnóstico presuntivo por los LOS Neisseria siguientes criterios:

• Características clínicas sugestivas
• Prueba de ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis +
• ↓ Probabilidad de otras etiologías

Inducción de la remisión

• Poliangeitis microscópica y granulomatosis con poliangeitis:
  • Ciclofosfamida + glucocorticoides son el criterio estándar para la inducción de la remisión.
  • Rituximab Rituximab A murine-derived monoclonal antibody and antineoplastic agent that binds specifically to the cd20 antigen and is used in the treatment of leukemia; lymphoma and rheumatoid arthritis. Immunosuppressants es una alternativa menos tóxica a la ciclofosfamida para la inducción de la remisión en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la granulomatosis con poliangeitis o la poliangeitis microscópica y es el 1er tratamiento aprobado por la Food and Drug Administration.
• Granulomatosis eosinofílica con poliangeitis:
  • Generalmente, la monoterapia con glucocorticoides es adecuada para el tratamiento de la granulomatosis eosinofílica con poliangeitis.
  • Los LOS Neisseria medicamentos citotóxicos (ciclofosfamida) son necesarios en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum < 20% de los LOS Neisseria individuos.
• La plasmaféresis puede ser necesaria según la enfermedad (e.g., glomerulonefritis rápidamente progresiva o hemorragia pulmonar).

Mantenimiento de la remisión

Una vez alcanzada la remisión, se cambia a agentes menos tóxicos:

• Azatioprina
• Rituximab Rituximab A murine-derived monoclonal antibody and antineoplastic agent that binds specifically to the cd20 antigen and is used in the treatment of leukemia; lymphoma and rheumatoid arthritis. Immunosuppressants
• Micofenolato mofetilo
• Metotrexato

Medidas generales

• Profilaxis antibiótica durante el tratamiento inmunosupresor
• Trimetoprim-sulfametoxazol para prevenir la neumonía por Pneumocystis

Tabla Comparativa

Tabla que muestra las características clínicas y de laboratorio sugerentes de los LOS Neisseria 3 tipos principales de vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus asociada a ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis:

Diagnóstico Diferencial

• Vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis inducida por medicamentos: las vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus ANCA ANCA Group of systemic vasculitis with a strong association with anca. The disorders are characterized by necrotizing inflammation of small and medium size vessels, with little or no immune-complex deposits in vessel walls. Rapidly Progressive Glomerulonephritis positivas por exposición a medicamentos están relacionadas con el desarrollo de vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus (propiltiouracilo, metimazol, carbimazol, hidralazina y minociclina), causando síntomas constitucionales como artralgias, fatiga y erupción cutánea. Sin embargo, también puede darse toda la gama de características clínicas (incluida la insuficiencia renal rápidamente progresiva y la hemorragia alveolar).
• Síndrome de Goodpasture: enfermedad autoinmune rara en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la que los LOS Neisseria anticuerpos atacan la membrana basal de los LOS Neisseria pulmones y los LOS Neisseria riñones, lo que provoca hemorragias pulmonares e insuficiencia renal. El síndrome de Goodpasture provoca daños permanentes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria pulmones y los LOS Neisseria riñones, y a menudo conduce a la muerte. El tratamiento incluye medicamentos supresores del sistema inmunológico (e.g., corticosteroides y ciclofosfamida) y plasmaféresis.
• Poliarteritis nodosa: una vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus sistémica de pequeños y medianos vasos. La poliarteritis nodosa afecta a la piel, los LOS Neisseria nervios periféricos, los LOS Neisseria músculos, las articulaciones, el tracto gastrointestinal y los LOS Neisseria riñones. Los LOS Neisseria individuos presentan síntomas inespecíficos, hipertensión, riesgo de infarto de miocardio y polineuropatía. La angiografía muestra un aspecto de cuentas con aneurismas y estenosis vascular alternados. El tratamiento es con regímenes inmunosupresores.
• Arteritis de células gigantes: es una vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus de las arterias medianas y grandes ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum particular de las arterias carótidas y la aorta Aorta The main trunk of the systemic arteries. Mediastinum and Great Vessels: Anatomy). Los LOS Neisseria individuos presentan cefalea de nueva aparición, arteria temporal sensible/endurecida, claudicación mandibular y amaurosis fugaz. Los LOS Neisseria estudios de laboratorio muestran elevación de VES y PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR). La biopsia muestra infiltración mononuclear de las paredes de los LOS Neisseria vasos y la formación de células gigantes. El tratamiento consiste en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la administración rápida de glucocorticoides.
• Púrpura de Henoch-Schönlein: vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus autoinmune de pequeños vasos. La afección se presenta típicamente como una tríada de dolor Dolor Inflammation abdominal, hematuria Hematuria Presence of blood in the urine. Renal Cell Carcinoma y erupción purpúrica. La fisiopatología implica la deposición de inmunocomplejos IgA IgA Represents 15-20% of the human serum immunoglobulins, mostly as the 4-chain polymer in humans or dimer in other mammals. Secretory iga is the main immunoglobulin in secretions. Immunoglobulins: Types and Functions en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum múltiples vasos tras un desencadenante. Los LOS Neisseria síntomas dependen de los LOS Neisseria tejidos irrigados por los LOS Neisseria vasos. La enfermedad tiene un diagnóstico clínico y se trata sintomáticamente.
• Artritis reumatoide: poliartritis inflamatoria que se presenta con dolor Dolor Inflammation en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum articulaciones simétricas. El dolor Dolor Inflammation empeora por la mañana, pero mejora durante el día. Las articulaciones interfalángicas proximales y metacarpofalángicas están incluidas, pero las articulaciones interfalángicas distales están exentas. El tratamiento es con AINE, metotrexato, sulfasalazina, hidroxicloroquina e inhibidores del factor de necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage tumoral-α (TNF-α, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés).
• Lupus eritematoso sistémico: afección inflamatoria crónica con afectación de la piel, las articulaciones, los LOS Neisseria riñones, las células sanguíneas y el SNC. La afección es un trastorno autoinmune asociado a la formación de autoanticuerpos como los LOS Neisseria anticuerpos antinucleares (ANA, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés), los LOS Neisseria anti-Smith y los LOS Neisseria anti-ADN de doble cadena. Las características incluyen erupción malar, dolor Dolor Inflammation articular, fiebre, proteinuria Proteinuria The presence of proteins in the urine, an indicator of kidney diseases. Nephrotic Syndrome in Children, hipertensión, anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types, linfopenia, convulsiones y/o psicosis.