Renal Involvement in Collagen Diseases
- Jul 29, 2010
Although it may not be accurate to classify all of these disorders as collagen diseases, disseminated lupus erythematosus, polyarteritis nodosa, microscopic angiitis scleroderma, Wegener’s granulomatosis, Henoch-Schönlein purpura and thrombotic thrombocytopenic purpura have been implicated in cases of glomerulonephritis.
The urine sediment is often diagnostic, containing erythrocytes and erythrocyte casts; renal tubular cells, including some filled with fat droplets; and waxy and granular broad casts. The presence of these formed elements is indicative of active glomerular and tubular disease.
The symptoms and signs of the primary disease, involving extrarenal findings (eg, pulmonary or ear, nose, or throat changes with Wegener’s granulomatosis; dermatologic abnormalities or carditis with systemic lupus erythematosus; dysphagia with scleroderma), as well as the presence of ANCA and other serologic tests, help to differentiate the form of collagen disease present.
Complete renal recovery from the disease is not likely to occur, although steroid and immunosuppressive drugs (alone or in combination) may be effective for longterm amelioration.
Flavio G. Vincenti, MD, & William J.C. Amend, Jr., MD
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