Clinicomorphological Comparisons of Renal Pathology Signs in Hemorrhagic Vasculitis with Extrarenal Manifestations of the Disease
The aim of the work: to make comparison of the nature of renal pathology and clinical course of hemorrhagic vasculitis, to assess the correlation of extrarenal manifestations of the disease with morphological signs of glomerulonephritis.
Materials and Methods. The study involved 144 patients (56 % men and 44 % women). Morphological study of renal tissues was performed in 21 patients (12 men and 9 women) with preserved renal function and urinary syndrome. Glomerulonephritis was diagnosed in 65 % of examined patients, I–IV degree chronic renal failure — in 17 %, nephrotic syndrome — in 8 %. Morphological class of glomerulonephritis was larger in men.
Results and Discussion. According to the results of variance and correlation analysis, the incidence of glomerulonephritis is affected by the overall level of activity of hemorrhagic vasculitis, integrated severity of extrarenal manifestations of the disease, the severity of cardiac pathology, at that glomerular filtration rate depends on the parameters of anti-neutrophil cytoplasmic antibodies, effective renal plasma flow — on the levels of IgM and circulating immune complexes, renal vascular resistance — on the content of IgG, and fibrinogen, fibronectin, C-reactive protein and IgA levels in the blood depend on the changes in the kidneys. The degree of glomerular IgA deposits in mesangium and interstitium, the incidence of fibrinoid changes and lymphohistiocytic vascular infiltration, deposits of IgM in the capillary endothelium, IgA, C3- and C1q-components of complement in the tubules depend on the gender of patient, and the severity of the tubular component — on the age of the patient.
Conclusions. In hemorrhagic vasculitis, clinicomorphological nature of kidney damage in the form of glomerulonephritis correlates with extrarenal manifestations of the disease, the degree of disease activity and concentration of immune inflammatory proteins in the blood.
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