Title: Clinical Presentation and Histopathological Profile and Renal Outcome of ANCA Associated Vasculitis

Authors: Dr C. Padmakumar, Dr Arun Varghese, Dr K.Shanmuga Sundaram

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i10.69

Abstract

Background:  Antineutrophil cytoplasmic antibody (ANCA) associated vasculitides usually affect various organ systems. Renal involvement usually presents as rapidly progressive renal failure. The clinico- pathological variants are Microscopicpolyangitis, Granulomatosis with polyangitis and renal limited vasculitis.

Aim: To study the epidemiological, clinical profile of ANCA associated vasculitis clinico- histo pathological correlation and renal outcome after treatment.

Materials & Methods: Retrospective and prospective observational study from June 2015 to May 2018. Patients with active vasculitis, ANCA positive serology and necrotizing/ crescentic pauci immune glomerulonephritis in biopsy were included. Patients aged<13 years, normal urine analysis and normal serum creatinine were excluded.

Observation & Conclusion: ANCA associated glomerulonephritis contributed to 2.8% of native kidney biopsies. Common age group was between 51 -60 years. The median age of presentation was 45±10.9 years. Male to female ratio was 1:1.6. 24(61.5%) patients had microspicpolyangitis (MPA), 11 (28%) patients granulomatosis with polyangitis (GPA), four had renal limited vasculitis. Six patients (15%) had ANCA negative vascultis. Joint involvement predicted the renal prognosis of ANCA vasculitis in this study. Sclerotic subtype of ANCA associated vasculitis had poor renal prognosis. 

Keywords: ANCA, Vasculitis, Renal failure, Renal biopsy.

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Corresponding Author

Dr K.Shanmuga Sundaram

Post Graduate, Department of General Medicine, Kanyakumari Government Medical College, Asaripallam