显微镜多血管炎5例分析

目的　提高对显微镜多血管炎临床特征的认识。方法　报道 5例显微镜多血管炎 ,并进行文献复习。结果　 4例以发热 ,3例以关节肿痛 ,1例以腹痛、腹泻和胃肠道出血为起病症状。 5例都有肾损害 ,3例肺受累。 5例血沉都增快 ,C反应蛋白增高 ,有不同程度贫血和低蛋白血症 ,补体都正常 ,核周型 抗中性粒细胞胞质抗体 (p ANCA)和髓过氧化物酶 抗中性粒细胞胞质抗体 (MPO ANCA)都阳性。结论　不明原因的长期发热、关节肿痛伴肺肾受累 (尤其肾功能急剧恶化的肾小球肾炎而无肾性高血压 ,不明原因的咯血 ) ,补体正常 ,p ANCA和MPO ANCA阳性 ,排除继发性小血管炎 ,应诊断显微镜多血管炎

Five cases of microscopic polyangiitis and literature review

Objective To enhance the understanding of clinical characteristic of micoscopic polyangiitis.Methods Five cases of microscopic polyangiitis were reported and related data reviewed.Results Initial symptoms of microscopic polyangiitis vary from patient to patient.In this report 4 cases manifestated irregular intermittent fever as mode of onset,3 cases had peripheral joint swelling pain,1 case suffered periumbilical pain concomitantly with diarrhea.Renal involvement occurred in all the five patients,3 cases had pulmonary involvement.The ESR and CRP went high;there were anemia,hypoalbuminemia,normal complement and positive p ANCA/MPO ANCA in all the five patients.Conclusion If his clinical data include long term unknown fever,arthruncus and arthralgia complicated with kidney lung involvement (especially glomerulonephritis with rapid exacerbating renal function but devoid of renal hypertension;hemoptysis with unknown cause),as well as normal complement,positive p ANCA/MPO ANCA,the patient must be diagnosed as microscopic polyangiitis,excluding secondary vasculitides.