[Renaliste] (sans objet)

[JMFaivre]

Dear Patricia


     Such a Kidney biopsy with cutaneous purpura. creatininemia up to 1.8 
the urine RBC's and
 3.2 g protein/24 hours.  is in deed  vasculitis with IgA_i mmune complex 
necrotizing glomerulonephritis
such as classical HSP

The point is : have  you an aetiological factor: streptococcus virus drug 
....to eradicate
any sign of Wegener ?
Test ANCA c or p  I-C  IgA-ANCA ....ACAN
May be you could observe spontaneous resolution......

But in idiopathic case we recommend steroids combined with cytoxan : 3 to 6 
months
to modulate with biological results

Best Wishes

JM Faivre



----- Original Message ----- 
From: "patricia khalil" <patriciakhalil at hotmail.com>
To: <renaliste at nephrodial.org>
Sent: Tuesday, March 13, 2007 10:18 PM
Subject: [Renaliste] (sans objet)


Message de la liste nephrologique francophone RENALISTE
----------------------------------
hi i want to discuss a case with you.


I have a patient who is 57 year old white female who has history of
schizophrenia and who had developped cutaneous lesions: started with
palpable purpura. by the time I saw her she had already necrosis in these
lesions. i was consulted aftre 2 weeks from her admission because her
creatinine was going up to 1.8 the urine sediemtn showed a lot of RBC's and
she had 3.2 g protein/24 hours. the skin biopsy showed leucocytoclastic
vasculitis and the IF was negative for IgA now the renal biopsy showed
crescentic glomerulonephritis with IgA.
how would you label her? HSP v/s vasculitis with i mmune complex necrotizing
glomerulonephritis?
would you recommend steroids or combine it with cytoxan?

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