RENAL: vasculitis Flashcards
What type of kidney injury can vasculitis cause?
Acute
How may vasculitis present?
Non-blanching rash
Knee/ankle pain
Inflammation of blood vessels in ENT
Neuro conditions
Pt with vague symptoms, haematuria and presence of ANCA
Dr Kenny’s workbook:
- raynauds
- msk - arthralgia, myalgia, prox muscle weakness
- cns - headaches, visual loss, stroke, seizures
- gi - abdo pain
- renal - haematuria
- limbs - neuropathy, digital ulcers, ischemia
How is vasculitis treated?
Plasma exchange- take blood from pt and pass through filter which removes the antibodies driving the condition
Cyclosporin
Tacrolimus
Mycophenate motefil
Cylcophosphamide
Dr Kenny wrokbook:
- 1st line = corticosteroids
2nd line = cytotoxic meds, immunomodulatory drugs and biological agents.
What antibody is implicated in vasculitis?
p-ANCA- anti-neurophil anti-cytoplasmic antibodies, they target neutrophil nucleus
c-ANCA- attaches to cytoplasm of nucleus
What antibodies can cause vasculitis?
P-ANCA
C-ANCA
What extra renal complications are related to AKPD?
Liver cysts
Berry aneurysms - check FHx of sudden death
What are complications of AKPD?
Renal failure
Hypertension
Infection
Pain
Why isn’t it useful doing genetic testing for AKPD?
High number of mutations - i.e. can not just test for ne mutation, have to test for 100s.
What is inheritance pattern of AKPD?
Autosomal dominant
Where is the mutation in Adult Polycystic Disease?
Polycystine gene, on chromosome 16 and chromosome 4
How is Adult polycystic disease inherited?
Autosomal dominant
How do you diagnose adult polycystic ovary syndrome?
Family history
Ultrasound- done over the age of 16 as cysts too small to be seen before then
What are the features of adult polycystic kidney disease?
Bilateral cysts on the kidneys
HTN
Risk of berry aneurysms
What are the complications of adult polycystic kidney disease?
Pain
Discomfort
Haematuria
Kidney failure
