[Renaliste] (sans objet)

[patricia khalil]

the complement levels were negative and the ANCA also nno evidence of 
infection, no phayryngitis, no endocarditis.

now the debate would be that if you think it is HSP then you would treat 
only with steroids but if you think it is IgA vasculitis then you would be 
inclined to treat with cytoxan.
I was trying to get literature also on immune complex crescentic GN but not 
much out there. most of the literature is about antiGBM disease and ANCA 
positive

>From: "JMFaivre" <faivre.j-m69 at wanadoo.fr>
>Reply-To: Liste de discussion des néphrologues francophones 
><renaliste at nephrodial.org>
>To: Liste de discussion des néphrologues 
>francophones<renaliste at nephrodial.org>
>Subject: Re: [Renaliste] (sans objet)
>Date: Tue, 13 Mar 2007 23:03:14 +0100
>
>Message de la liste nephrologique francophone RENALISTE
>----------------------------------
>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?
>
>_________________________________________________________________
>Express yourself instantly with MSN Messenger! Download today it's FREE!
>http://messenger.msn.click-url.com/go/onm00200471ave/direct/01/
>
>_______________________________________________
>Si vous souhaitez modifier votre abonnement cliquez sur l'adresse :
>http://rdplf.vps-hostingfr.com/mailman/listinfo/renaliste
>RENALISTE est hébergé gracieusement par le RDPLF (http://www.rdplf.org)
>
>
>
>
>--
>No virus found in this incoming message.
>Checked by AVG Free Edition.
>Version: 7.5.446 / Virus Database: 268.18.9/719 - Release Date: 12/03/2007
>08:41
>
>
>
>_______________________________________________
>Si vous souhaitez modifier votre abonnement cliquez sur l'adresse :
>http://rdplf.vps-hostingfr.com/mailman/listinfo/renaliste
>RENALISTE est hébergé gracieusement par le RDPLF (http://www.rdplf.org)

_________________________________________________________________
FREE pop-up blocking with the new MSN Toolbar - get it now! 
http://toolbar.msn.click-url.com/go/onm00200415ave/direct/01/