Vasculite IgA e glomerulonefrite C3: Um Doente…Várias Doenças Autoimunes

Detalhes bibliográficos
Autor(a) principal: Gaudêncio,Margarida
Data de Publicação: 2022
Outros Autores: Lameiras,Ana Catarina, Mendonça,Teresa
Tipo de documento: Relatório
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-06282022000400357
Resumo: Abstract Leucocytoclastic vasculitis refers to a small vessel vasculitis caused by immune complexes, infections and medications. IgA or IgM/IgG immune complexes can be found in direct immunofluorescence studies suggesting specific forms of leucocytoclastic vasculitis. Some authors suggested that IgA vasculitis and IgA nephropathy were two clinical manifestations of the same disease. From a histological point of view, it is not possible to distinguish a glomerulonephritis as part of an IgA vasculitis from an IgA nephropathy. The authors present a case of a 50-year-old woman diagnosed with vitiligo ad immune thrombocytopenic purpura (ITP). ITP was diagnosed 2 years before the present case. She presented to the autoimmune diseases’ appointment with a pruriginous rash of the lower extremities over the last 3 months. Skin biopsy was suggestive of leukocytoclastic vasculitis, revealing deposits of C3, IgG (less intensity) and IgA. IgA vasculitis was then assumed. After a few weeks, she kept peripheral edema, but an increasing decline in renal function was detected. Therefore, a renal biopsy was performed, which revealed endocapilar proliferative glomerulonephritis and predominantly C3 mesangial deposits, with IgA and vestigial IgM. These results were compatible with a C3 glomerulonephritis. The patient was started on systemic steroid treatment with prednisolone 1 mg/kg/day and ramipril 2.5 mg/day with progressive normalization of renal function. With this case, the authors emphasize the possibility that all these manifestations could be part of the same disease spectrum, but also, the importance of complement activation. So, this case may constitute additional evidence of the complement activation in pathogenesis of this vasculitis, however, further investigation is need, particularly to understand C3 glomerulonephritis, a rare kidney disease.
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spelling Vasculite IgA e glomerulonefrite C3: Um Doente…Várias Doenças AutoimunesComplement C3Glomerulonephritis, IgAIgA VasculitisKidney DiseasesKidney GlomerulusAbstract Leucocytoclastic vasculitis refers to a small vessel vasculitis caused by immune complexes, infections and medications. IgA or IgM/IgG immune complexes can be found in direct immunofluorescence studies suggesting specific forms of leucocytoclastic vasculitis. Some authors suggested that IgA vasculitis and IgA nephropathy were two clinical manifestations of the same disease. From a histological point of view, it is not possible to distinguish a glomerulonephritis as part of an IgA vasculitis from an IgA nephropathy. The authors present a case of a 50-year-old woman diagnosed with vitiligo ad immune thrombocytopenic purpura (ITP). ITP was diagnosed 2 years before the present case. She presented to the autoimmune diseases’ appointment with a pruriginous rash of the lower extremities over the last 3 months. Skin biopsy was suggestive of leukocytoclastic vasculitis, revealing deposits of C3, IgG (less intensity) and IgA. IgA vasculitis was then assumed. After a few weeks, she kept peripheral edema, but an increasing decline in renal function was detected. Therefore, a renal biopsy was performed, which revealed endocapilar proliferative glomerulonephritis and predominantly C3 mesangial deposits, with IgA and vestigial IgM. These results were compatible with a C3 glomerulonephritis. The patient was started on systemic steroid treatment with prednisolone 1 mg/kg/day and ramipril 2.5 mg/day with progressive normalization of renal function. With this case, the authors emphasize the possibility that all these manifestations could be part of the same disease spectrum, but also, the importance of complement activation. So, this case may constitute additional evidence of the complement activation in pathogenesis of this vasculitis, however, further investigation is need, particularly to understand C3 glomerulonephritis, a rare kidney disease.Círculo Médico2022-12-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-06282022000400357Gazeta Médica v.9 n.4 2022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-06282022000400357Gaudêncio,MargaridaLameiras,Ana CatarinaMendonça,Teresainfo:eu-repo/semantics/openAccess2024-02-06T17:32:18Zoai:scielo:S2184-06282022000400357Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:35:06.419380Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Vasculite IgA e glomerulonefrite C3: Um Doente…Várias Doenças Autoimunes
title Vasculite IgA e glomerulonefrite C3: Um Doente…Várias Doenças Autoimunes
spellingShingle Vasculite IgA e glomerulonefrite C3: Um Doente…Várias Doenças Autoimunes
Gaudêncio,Margarida
Complement C3
Glomerulonephritis, IgA
IgA Vasculitis
Kidney Diseases
Kidney Glomerulus
title_short Vasculite IgA e glomerulonefrite C3: Um Doente…Várias Doenças Autoimunes
title_full Vasculite IgA e glomerulonefrite C3: Um Doente…Várias Doenças Autoimunes
title_fullStr Vasculite IgA e glomerulonefrite C3: Um Doente…Várias Doenças Autoimunes
title_full_unstemmed Vasculite IgA e glomerulonefrite C3: Um Doente…Várias Doenças Autoimunes
title_sort Vasculite IgA e glomerulonefrite C3: Um Doente…Várias Doenças Autoimunes
author Gaudêncio,Margarida
author_facet Gaudêncio,Margarida
Lameiras,Ana Catarina
Mendonça,Teresa
author_role author
author2 Lameiras,Ana Catarina
Mendonça,Teresa
author2_role author
author
dc.contributor.author.fl_str_mv Gaudêncio,Margarida
Lameiras,Ana Catarina
Mendonça,Teresa
dc.subject.por.fl_str_mv Complement C3
Glomerulonephritis, IgA
IgA Vasculitis
Kidney Diseases
Kidney Glomerulus
topic Complement C3
Glomerulonephritis, IgA
IgA Vasculitis
Kidney Diseases
Kidney Glomerulus
description Abstract Leucocytoclastic vasculitis refers to a small vessel vasculitis caused by immune complexes, infections and medications. IgA or IgM/IgG immune complexes can be found in direct immunofluorescence studies suggesting specific forms of leucocytoclastic vasculitis. Some authors suggested that IgA vasculitis and IgA nephropathy were two clinical manifestations of the same disease. From a histological point of view, it is not possible to distinguish a glomerulonephritis as part of an IgA vasculitis from an IgA nephropathy. The authors present a case of a 50-year-old woman diagnosed with vitiligo ad immune thrombocytopenic purpura (ITP). ITP was diagnosed 2 years before the present case. She presented to the autoimmune diseases’ appointment with a pruriginous rash of the lower extremities over the last 3 months. Skin biopsy was suggestive of leukocytoclastic vasculitis, revealing deposits of C3, IgG (less intensity) and IgA. IgA vasculitis was then assumed. After a few weeks, she kept peripheral edema, but an increasing decline in renal function was detected. Therefore, a renal biopsy was performed, which revealed endocapilar proliferative glomerulonephritis and predominantly C3 mesangial deposits, with IgA and vestigial IgM. These results were compatible with a C3 glomerulonephritis. The patient was started on systemic steroid treatment with prednisolone 1 mg/kg/day and ramipril 2.5 mg/day with progressive normalization of renal function. With this case, the authors emphasize the possibility that all these manifestations could be part of the same disease spectrum, but also, the importance of complement activation. So, this case may constitute additional evidence of the complement activation in pathogenesis of this vasculitis, however, further investigation is need, particularly to understand C3 glomerulonephritis, a rare kidney disease.
publishDate 2022
dc.date.none.fl_str_mv 2022-12-01
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dc.publisher.none.fl_str_mv Círculo Médico
publisher.none.fl_str_mv Círculo Médico
dc.source.none.fl_str_mv Gazeta Médica v.9 n.4 2022
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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