RESUMO
P-ANCA small vessel vasculitis is multisystemic disease, especially frequently involving the kidney. Diagnosis is delayed because it's non-specific clinical manifestation. Recently ANCA becomes available tools for diagnosis of vasculitis. Infection and gastrointestinal complications are relatively common in vasculitis. But spontaneous rupture of gastrointestinal artery is a rare complication. A 61-year-old housewife was admitted due to poor oral intake, weight loss and microscopic hematuria. Renal biopsy showed an extensive necrotizing glomerulonephritis, consistent with Wegener's granulomatosis or microscopic polyangitis. Serum test showed positive for P-ANCA. Despite steroid therapy, she expired due to spontaneous rupture of right gastroepiploic artery.
Assuntos
Humanos , Pessoa de Meia-Idade , Anticorpos Anticitoplasma de Neutrófilos , Artérias , Biópsia , Diagnóstico , Artéria Gastroepiploica , Glomerulonefrite , Hematúria , Hemorragia , Rim , Ruptura Espontânea , Vasculite , Granulomatose com Poliangiite , Redução de PesoRESUMO
Systemic lupus erythematosus(SLE) is a multisys-temic disease. Peripheral neuropathy occurs in about 10% of patients with SLE. Chronic inflammatory demyelinating polyneurpathy has been reported rarely in SLE. We experienced a case of chronic inflammatory polyneuropathy in lupus nephritis. 32-year-old housewife presented to chronic progressive muscle weakness and heavy proteinuria. Kidney biopsy showed compatible with lupus nephritis (WHO Class V, membranous nephropathy). Nerve conduction studies showed reduction in conduction velocity and sural nerve biopsy revealed demyeli-nating polyneuropathy. Steroid therapy led to improvement in clinical symptoms and proteinuria.