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VASKULITE BAĞLI BÖBREK YETERSİZLİĞİNDE İMMUNOSUPRESİF TEDAVİNİN PROGNOSTİK ÖNEMİ -Bir Mikroskopik Polianjiit vakası nedeniyle-

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2000

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
The importance ofearly and intensive therapy in vasculitis- A casc of microscopic poliangii-lis. Microscopic poliangiitis (MPA) is a systemic vasculitis characterized with small vessel (arterioi, venul, capİllary) diseasc. It generally presents with rapidly progressive glomerulo-nephritis and sometimes with hemoptysis. It should be dİfferentiated from Wegener granulo-matosis (WG) which is also an antineutrophil eytoplasmie autoantibody (ANCA) positive small vessel vasculitis presenting with a similar clinical syndrome. VVegener's granulomatosis is an acute disease whereas MPA is a slowly progressing one. Moreover c-ANCA (especially PR3-ANCA) is positive in WG, but p-ANCA (especially MPO-ANCA) is positive in MPA. Furthermore the granulomatous lesion observed histopathologically İn WG is absent in MPA. in organ damage due to vaculitides, the usage of combination therapy of corticosteroids with cyototoxic drugs may provide good results. In our case with the early initiation of agressive immunosupressive therapy, the renal faihıre regressed and the need for hemodialysis disappea-red. In addition, the importance of renal biopsy in patients with renal failure due to multisyste-mic disease is once more acknowlcdged.
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Abstract (Original Language): 
Mikroskopik polianjiit (MPA), küçük damar tutulumu (arterioi, venül, kapiller) ile karakterize bir sislenıik vaskülitür. Çoğu kez hızlı ilerleyen glomerulonefrit vc bazen buna eşlik eden abondan hemoptizi ile seyreder. Gerek klinik olarak, gerekse ANCA (Antincutropbil cytoplas-mic autoantibody) pozitif küçük damar vasküliü olmaları nedeniyle Y/egener granulomatozu (WG) ile ayırıcı tanısı gerekir. Wegener granulomatozu akut bir hastalık olmasına karşın MPA daha yavaş seyididir. Ayrıca WG'da c-ANCA (özellikle PR3- ANCA), MPA'de ise p-ANCA (Özellikle MPO-ANCA) pozitif bulunur. Histopatolojik olarak WG'da görülen granulomatöz lezyonun MPA'de bulunmaması da ayırıcı tamda önemlidir. Vaskülite bağlı organ hasarında kortikosteroid ve sitotoksik ajanlar ile kombine tedaviye dramatik yanıt alınabilir. Olgumuzda da erken ve yoğun bir immunosupresif tedavi ile böbrek yetersizliğinin belirgin olarak düzelmesi vc diyaliz ihtiyacının gerilemesi vurgulanmıştır. Ayrıca multisistemik hastalıklara bağlı böbrek yetersizliğinde böbrek biyopsisinin prognostik önemi de dikkati çekmiştir
FULL TEXT (PDF): 
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  • 2
192-198
  • Turkish

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