Abstract:Objective: To investigate the clinical and pathological characteristics of different age groups in adults with ANCA-associated vasculitis and renal damage. Methods: 76 adult patients (age ≥ 18 years) were selected and divided into groups according to age. The patients with age ≥ 60 years old were 36 cases in the elderly group, including 12 males and 24 females; the patients with age ≤ 18 years old < 60 years old were 40 cases in the young and middle age group, including 13 males and 27 females. The clinical data and renal pathological results of the two groups were retrospectively analyzed. Results: In adult patients with ANCA associated vasculitis and renal damage,the clinical manifestations of cough, moderate to severe renal insufficiency, anemia, hypertension and gross Hematuria in the observation group were significantly higher than those in the control group (P<0.05). The pathological types of the two groups were mainly segmental type, and the old aged group accounted for 36.1%, the Middle-aged young group accounted for 67.5%; apart from segmental type, crescentic and scleorotic typeswas more common, accounted for 27.8% and 22.2% in the observation group; crescentic type accounted for 20.0% in the control group. The prevalence of crescent formation, glomerular scleorosis, interstitial fibrosis and tubular atrophy were significantly higher in the observation group than those in the control group, and the differences were statistically significant (P<0.01). Conclusions: The clinical manifestations of elderly patients with renal impairment of ANCA-associated vasculitis are more complicated, especially in the aspects of respiratory system and renal function. With various pathological types, both active and chronic renal lesions in the elderly patients are significant. Severe glomerular damage and tubulointerstitial damage are common.
汤海莲, 李建军, 毕杰, 张文生, 陈光磊, 杨再波. 不同年龄段成人ANCA相关性血管炎肾损害患者临床病理差异性分析[J]. 河北医学, 2020, 26(7): 1152-1156.
TANG Hailian, LI Jianjun, BI Jie, et al. Analysis of clinical and pathological characteristics in adults patients with ANCA associated vasculitis and renal involvement. HeBei Med, 2020, 26(7): 1152-1156.
[1] 谢荣华,吴振彪,贾俊峰,等.84例抗中性粒细胞胞浆抗体相关性血管炎临床特征分析[J].宁夏医科大学学报,2016,38(12):1408-1410. [2] Chen M, Kallenberg CEG. The environment, geoepidemiology and ANCA-ssociated vasculitides[J]. Autoimmunity Reviews, 2010, 9(5): 293-A298. [3] Charles J J, Xiao H, Hu P. Complement in ANCA-associated vasculitis[J]. Seminars in nephrology, 2013, 33(6): 557-564. [4] Chang W M, Dakanali M, Capule C C, et al. ANCA: A Family of Fluorescent Probes that Bind and Stain Amyloid Plaques in Human Tissue[J]]. ACS Chem Neurosci, 2011, 2(5): 249-255. [5] Guilpain P, Chanseaud Y, Tamby M C, et al. [Pathogenesis of primary systemic vasculitides (I): ANCA-positive vasculitides]. Presse Med. 2005. 34(14): 1013-1022. [6] Chen M, Yu F, Zhang Y, et al. Antineutrophil cytoplasmic autoantibody-associated vasculitis in older patients[J]. Medicine (Baltimore), 2008, 87(4): 203-209. [7] Berden A E, Ferrario F, Hagen E C, et al. Histopathologic classification of ANCA-associated glomerulonephritis[J]. J Am Soc Nephrol, 2010, 21(10): 1628-1636. [8] Alan D. Salama. Relapse in Anti-Neutrophil Cytoplasm Antibody (ANCA)–Associated Vasculitis[J]. Kidney International Reports,2020,5(1).7-12. [9] Chang D Y,Wu L H,Liu G, et al.Re-evaluation of the Histopathologic classification of ANCA-associated glomerulonephritis:a syudy of 121 patients in a single center[J]. Nephrol Dial Transplant,2012,27(6): 2343-2349. [10] Yamagata K, Usui J, Saito C, et al. ANCA-associated systemic vasculitis in Japan: clinical features and prognostic changes[J]. Clin Exp Nephrol, 2012, 16(4): 580-588.