Microscopic polyangiitis – a view of the problem through the lens of a nephrologist

Abstract

The article presents two clinical cases of microscopic polyangiitis in patients with symptoms of glomerulonephritis with renal failure, which were preceded by such nonspecific symptoms as: abdominal syndrome, high blood pressure, arthralgia, myalgia, weight loss, uveitis, shortness of breath, general weakness. Clinical and laboratory-instrumental aspects of diseases are analyzed. Emphasized the feasibility of early diagnosis, adequate therapy appointment. The aim of the article is to show that only with timely prescribing of pathogenetic therapy it is possible to achieve clinical and laboratory remission and, even, to cease hemodialysis sessions. It was described two clinical cases of microscopic polyangiitis in patients with symptoms of glomerulonephritis with renal failure. Approaches to complex treatment of patients with the use of pathogenetic and the possibility of using renal replacement therapy were discussed. After verifying the diagnosis, all patients started immunosuppression with corticosteroids and cytostatics. It is shown that only with timely prescribing of pathogenetic therapy it is possible to achieve clinical and laboratory remission. Clinical examples demonstrate to physicians that systemic vasculitis can often hide under the «mask» of other diseases and require timely diagnosis and immediate pathogenetic treatment.