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Renal Involvement in Vasculitic Syndromes in Children

  • Norman J. Siegel
  • Karen M. Gaudio
Part of the Developments in Nephrology book series (DINE, volume 17)

Abstract

The nomenclature and classification of the vasculitic syndromes are bewildering. The term, vasculitis, is used to describe a wide variety of clinical disorders of diverse presentations and differing etiology (Figure 1). The common denominator for each of these entities is inflammation and necrosis of blood vessels. Although the kidney may be involved in disorders of larger blood vessels, such as polyarteritis, renal involvement is much more of a clinical component in small vessel vasculitis. In these disorders, inflammation and necrosis affects primarily glomerular capillaries and renal biopsy specimens will demonstrate a focal necrotizing glomerulonephritis (1). Necrosis of the glomerular capillary wall results in exudation into Bowman’s space and stimulates crescent formation. Within the same biopsy specimen, lesions of differing age and severity are characteristic as is some interstitial inflammation. This interstitial infiltration consists of eosinophils, plasma cells and lymphocytes. The lesions which are seen on light microscopy are non-specific and occur in a number of different syndromes (1).

Keywords

Systemic Lupus Erythematosus Lupus Nephritis Giant Cell Arteritis Renal Involvement Takayasu Arteritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Spargo, B., Seymour, A.E. and Ordonez, N.G.: Renal biopsy pathology with diagnostic and therapeutic implications: Chapter 12, VASCULITIS, John Wiley and Sons, New York, 1980.Google Scholar
  2. 2.
    Siegel, N.J. and Hayslett, J.P.: Renal involvement in systemic lupus erythematosus. In: The Kidney in Systemic Disease, Second Edition, Suki, W.N. and Eknoyan, G. (eds), John Wiley and Sons, New York, p. 55, 1981.Google Scholar
  3. 3.
    Cohen, A.S., Reynolds, W.E., Franklin, E.C., et al: Preliminary criteria for the classification of systemic lupus erythematosus. Bull Rheum. Dis., 21: 643, 1971.Google Scholar
  4. 4.
    Dubois, E.L.: Lupus Erythematosus, Second Edition, McGraw-Hill, New York, 1974.Google Scholar
  5. 5.
    Harvey, A.M., Shulman, L.E., Tumulty, A., et al: Systemic lupus erythematosus: Review of the literature and clinical analysis of 138 cases. Medicine, 33: 291, 1954.PubMedCrossRefGoogle Scholar
  6. 6.
    Haserick, J.R.: Unpublished data.Google Scholar
  7. 7.
    Larson, D.L.: Systemic Lupus Erythematosus. Little Brown & Co., Boston, 1961.Google Scholar
  8. 8.
    Libit, S.A., Burke, B., Michael, A.F., et al: Extramembranous glomerulonephritis in childhood: Relationship to systemic lupus erythematosus. J. Pediatr., 88: 394, 1976.PubMedCrossRefGoogle Scholar
  9. 9.
    Kallen, R.J., Soo-Kwang, L., Arsonson, A.J., et al: Idiopathic membranous glomerulopathy preceding the emergence of systemic lupus erythematosus in two children. J. Pediatr., 90: 72, 1977.PubMedCrossRefGoogle Scholar
  10. 10.
    Hargraves, M.M., Richmond, H. and Morton, R.: Presentation of two bone marrow elements: The “tart” cell and “L.E.” cell. Proc. Staff Mayo Clin., 23: 25, 1948.Google Scholar
  11. 11.
    Gonzales, E.N. and Rothfield, N.F.: Immunoglobulin class and pattern of nuclear fluorescence in systemic lupus erythematosus. N. Engl. J. Med., 274: 133, 1966.CrossRefGoogle Scholar
  12. 12.
    Koller, S.R., Johnston, C.L., Moncure, C.W., et al: Lupus erythematosus cell preparation: Antinuclear factor incongruity. Am. J. Clin. Pathol., 66: 495, 1976.PubMedGoogle Scholar
  13. 13.
    Farr, R.S.: A quantitative immunochemical measure of the primary interaction between I BSA and antibody. J. Infect. Dis., 103: 239, 1958.PubMedCrossRefGoogle Scholar
  14. 14.
    Hughes, G.R.: Significance of anti-DNA antibodies in systemic lupus erythematosus. Lancet, 2: 861, 1971.PubMedCrossRefGoogle Scholar
  15. 15.
    Casals, S.P., Friou, G.P. and Myers, L.L.: Significance of antibody to DNA systemic lupus erythematosus. Arthritis Rheum., 7: 379, 1964.PubMedCrossRefGoogle Scholar
  16. 16.
    Tan, E.M., Schur, P.H., Carr, R.I., et al: Deoxyribonucleic acid (DNA) and antibodies to DNA in serum patients with systemic lupus erythematosus. J. Clin. Invest., 45: 1732, 1966.PubMedCrossRefGoogle Scholar
  17. 17.
    Adler, M.K., Baumgarten, A., Hecht, B., et al: Prognostic significance of DNA-binding capacity patients with lupus nephritis. Ann. Rheum. Dis., 35: 444, 1975.CrossRefGoogle Scholar
  18. 18.
    Hecht, B., Siegel, N.J., Adler, M., et al: Prognostic indices in lupus nephritis. Medicine, 55: 163, 1976.PubMedCrossRefGoogle Scholar
  19. 19.
    Dubois, E.L. and Tuffanelli, D.L.: Clinical manifestations of systemic lupus erythematosus: Computer analysis of 520 cases. JAMA, 190: 104, 1964.PubMedGoogle Scholar
  20. 20.
    Rothfield, N.F., McClusky, R.T. and Baldwin, D.S.: Renal disease in systemic lupus erythematosus. N. Engl. J. Med., 269: 537, 1963.PubMedCrossRefGoogle Scholar
  21. 21.
    Meislin, A.G. and Rothfield, N.: Systemic lupus erythematosus in childhood. Pediatrics, 42: 37, 1968.PubMedGoogle Scholar
  22. 22.
    Koffler, D., Agnello, V., Carr, I., et al: Variable patterns of immunoglobulin and complement deposition in the kidneys of patients with systemic lupus erythematosus. Am. J. Pathol., 56: 305, 1969.PubMedGoogle Scholar
  23. 23.
    Dujovne, I., Pollak, V.E., Pirani, C.L., et al: The distribution and character of glomerular deposits in systemic lupus erythematosus. Kidney Inter., 2: 33, 1972.CrossRefGoogle Scholar
  24. 24.
    Dillard, M.G., Tillman, R.L. and Sampson, C.C.: Lupus nephritis: Correlations between clinical course and presence of electron-dense deposits. Lab. Invest., 32: 261, 1975.PubMedGoogle Scholar
  25. 25.
    Houghton, D., Bennett, W., Bardana, E., et al: Silent renal involvement in systemic lupus erythematosus. Kidney Inter., 8: 499, 1975.Google Scholar
  26. 26.
    Mahajan, S.K., Ordonez, N.G., Feitelson, P.J., et al: Diffuse lupus glomerulonephritis without clinical renal involvement, abstracted, Am. Soc. Nephrology, 9th Annual Meeting, Nov. 1976, p. 17.Google Scholar
  27. 27.
    Crumb, C.: Renal involvement in Schonlein-Henoch Syndrome: In: The Kidney in Systemic Disease, Suki, W.N. and Eknoyan, G. (eds), John Wiley and Sons, New York, p. 99, 1981.Google Scholar
  28. 28.
    Gairdner, D.: The Schonlein-Henoch syndrome (anaphylactoid purpura). Q. J. Med., 17: 95, 1948.PubMedGoogle Scholar
  29. 29.
    Trygstad, C.W., Stiehm, E.R.: Elevated serum IgA globulin in anaphylactoid purpura. Pediatrics, 47: 1023, 1971.PubMedGoogle Scholar
  30. 30.
    Meadow, S.R., Glasgow, E.R., White, R.H.R., et al: Schonlein-Henoch nephritis. Q. J. Med., 163: 241, 1972.Google Scholar
  31. 31.
    Meadow, S.R., Glasgow, E.F., White, R.H.R., et al: Schonlein-Henoch nephritis. In: Glomerulonephritis, Kincaid-Smith, P., Matthew, T.H., Becker, E.L. (eds), John Wiley & Sons, New York, vol. 2, p. 1089, 1973.Google Scholar
  32. 32.
    Wegener, F.: Uber generalisierte, septische Gefasserkrankunjen Vesh. Dtsch Ges. Pathology, 29: 202, 1936.Google Scholar
  33. 33.
    Baliga, R., et al: Wegener’s granulomatosis in childhood. Pediatrics 61: 286, 1978.PubMedGoogle Scholar
  34. 34.
    Moorthy, A.V., Chesney, R.W., Segar, W.E. and Groshong, T.: Wegener granulomatosis in childhood: Prolonged survival following cytotoxic therapy. J. Pediatr., 91: 616, 1977.PubMedCrossRefGoogle Scholar
  35. 35.
    Fahey, J., Leonard, E., Churg, J. and Godman, G.C.: Wegener’s granulomatosis. Am. J. Med., 17: 168, 1954.PubMedCrossRefGoogle Scholar
  36. 36.
    Appel, G.B., Gee, B., Kashgarian, M. and Hayslett, J.P.: Wegener’s granulomatosis: Clinical-pathological correlations and long-term course. Am. J. Kidney Dis., 1: 27, 1981.PubMedGoogle Scholar
  37. 37.
    Fauci, A.S., Haynes, B.F., Katz, P. and Wolff, S.M.: Wegener’s granulomatosis: Prospective clinical and therapeutic experience with 85 patients for 21 years. Ann. Internal Med., 98: 76, 1983.Google Scholar

Copyright information

© Martinus Nijhoff Publishing, Boston 1987

Authors and Affiliations

  • Norman J. Siegel
  • Karen M. Gaudio

There are no affiliations available

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