Microscopic polyangiitis laboratory findings: Difference between revisions

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{{Microscopic polyangiitis}}
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==Overview==
==Overview==
When suspecting a patient with microscopic polyangiitis(MPO) an [[Anti-neutrophil cytoplasmic antibody|ANCA]] test should be an idle choice.Laboratory findings consistent with the diagnosis of Microscopic polyangiitis include [[leukocytosis]], elevated [[erythrocyte sedimentation rate]], [[proteinuria]], [[hematuria]], red cell casts, elevated blood [[urea]] [[nitrogen]], elevated serum [[creatinine]], and [[anti-neutrophil cytoplasmic antibodies]].


== Laboratory Findings ==
Laboratory findings consistent with the diagnosis of [[Microscopic polyangiitis|Microscopic polyangiiti]]<nowiki/>s include, [[Anti-neutrophil cytoplasmic antibody|antineutrophil cytoplasmic antibody]], elevated blood [[urea]] [[nitrogen]], elevated serum [[creatinine]], elevated [[erythrocyte sedimentation rate]], [[proteinuria]], [[hematuria]], red cell [[casts]], and [[leukocytosis]].
===Blood Work-up<ref name="pmid10088763">{{cite journal |vauthors=Guillevin L, Durand-Gasselin B, Cevallos R, Gayraud M, Lhote F, Callard P, Amouroux J, Casassus P, Jarrousse B |title=Microscopic polyangiitis: clinical and laboratory findings in eighty-five patients |journal=Arthritis Rheum. |volume=42 |issue=3 |pages=421–30 |date=March 1999 |pmid=10088763 |doi=10.1002/1529-0131(199904)42:3<421::AID-ANR5>3.0.CO;2-6 |url=}}</ref><ref name="pmid9507222">{{cite journal |vauthors=Hagen EC, Daha MR, Hermans J, Andrassy K, Csernok E, Gaskin G, Lesavre P, Lüdemann J, Rasmussen N, Sinico RA, Wiik A, van der Woude FJ |title=Diagnostic value of standardized assays for anti-neutrophil cytoplasmic antibodies in idiopathic systemic vasculitis. EC/BCR Project for ANCA Assay Standardization |journal=Kidney Int. |volume=53 |issue=3 |pages=743–53 |date=March 1998 |pmid=9507222 |doi=10.1046/j.1523-1755.1998.00807.x |url=}}</ref><ref name="pmid8796093">{{cite journal |vauthors=Lhote F, Cohen P, Généreau T, Gayraud M, Guillevin L |title=Microscopic polyangiitis: clinical aspects and treatment |journal=Ann Med Interne (Paris) |volume=147 |issue=3 |pages=165–77 |date=1996 |pmid=8796093 |doi= |url=}}</ref>===
* Anti-neutrophil cytoplasmic antibody test.
* MPA is primarily associated with MPO-ANCA.<ref name="pmid15857795">{{cite journal |vauthors=Savige J, Pollock W, Trevisin M |title=What do antineutrophil cytoplasmic antibodies (ANCA) tell us? |journal=Best Pract Res Clin Rheumatol |volume=19 |issue=2 |pages=263–76 |date=April 2005 |pmid=15857795 |doi=10.1016/j.berh.2004.10.003 |url=}}</ref>
* Complete blood count.
* Serum creatinine.
* Blood urea nitrogen.
* leukocytosis.
===Urinalysis<ref name="pmid218413332">{{cite journal |vauthors=Okura T, Miyoshi K, Jotoku M, Enomoto D, Irita J, Nagao T, Ito R, Higaki J |title=A patient with myeloperoxidase antineutrophil cytoplasmic antibody-positive polyangiitis who developed sensorineural hearing loss and scleritis |journal=Intern. Med. |volume=50 |issue=16 |pages=1725–8 |date=2011 |pmid=21841333 |doi= |url=}}</ref><ref name="pmid100887632">{{cite journal |vauthors=Guillevin L, Durand-Gasselin B, Cevallos R, Gayraud M, Lhote F, Callard P, Amouroux J, Casassus P, Jarrousse B |title=Microscopic polyangiitis: clinical and laboratory findings in eighty-five patients |journal=Arthritis Rheum. |volume=42 |issue=3 |pages=421–30 |date=March 1999 |pmid=10088763 |doi=10.1002/1529-0131(199904)42:3<421::AID-ANR5>3.0.CO;2-6 |url=}}</ref>  ===
* Proteinuria
* Hematuria
* Red cell casts
===Biopsy===
Biopsy of the involved skin, lung, renal, and nerve can be made to help establish a diagnosis of Microscopic polyangiitis.<ref name="pmid9493653">{{cite journal |vauthors=Schnabel A, Holl-Ulrich K, Dalhoff K, Reuter M, Gross WL |title=Efficacy of transbronchial biopsy in pulmonary vaculitides |journal=Eur. Respir. J. |volume=10 |issue=12 |pages=2738–43 |date=December 1997 |pmid=9493653 |doi= |url=}}</ref><ref name="pmid10941351">{{cite journal |vauthors=Lauque D, Cadranel J, Lazor R, Pourrat J, Ronco P, Guillevin L, Cordier JF |title=Microscopic polyangiitis with alveolar hemorrhage. A study of 29 cases and review of the literature. Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (GERM"O"P) |journal=Medicine (Baltimore) |volume=79 |issue=4 |pages=222–33 |date=July 2000 |pmid=10941351 |doi= |url=}}</ref>
* Skin biopsy is characterized by the presences of immunoglobulins and complement components.
* Renal biopsy is characterized as a crescent formation with focal necrosis.
* Lung biopsy is characterized by alveolar capillaritis.
* Nerve biopsy is characterized by vascular necrosis of small and medium-sized vessels.
==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 17:53, 30 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2]Associate Editor(s)-in-Chief: Krzysztof Wierzbicki M.D. [3]Vamsikrishna Gunnam M.B.B.S [4]

Overview

When suspecting a patient with microscopic polyangiitis(MPO) an ANCA test should be an idle choice.Laboratory findings consistent with the diagnosis of Microscopic polyangiitis include leukocytosis, elevated erythrocyte sedimentation rate, proteinuria, hematuria, red cell casts, elevated blood urea nitrogen, elevated serum creatinine, and anti-neutrophil cytoplasmic antibodies.

Laboratory Findings

Laboratory findings consistent with the diagnosis of Microscopic polyangiitis include, antineutrophil cytoplasmic antibody, elevated blood urea nitrogen, elevated serum creatinine, elevated erythrocyte sedimentation rate, proteinuria, hematuria, red cell casts, and leukocytosis.

Blood Work-up[1][2][3]

  • Anti-neutrophil cytoplasmic antibody test.
  • MPA is primarily associated with MPO-ANCA.[4]
  • Complete blood count.
  • Serum creatinine.
  • Blood urea nitrogen.
  • leukocytosis.

Urinalysis[5][6]  

  • Proteinuria
  • Hematuria
  • Red cell casts

Biopsy

Biopsy of the involved skin, lung, renal, and nerve can be made to help establish a diagnosis of Microscopic polyangiitis.[7][8]

  • Skin biopsy is characterized by the presences of immunoglobulins and complement components.
  • Renal biopsy is characterized as a crescent formation with focal necrosis.
  • Lung biopsy is characterized by alveolar capillaritis.
  • Nerve biopsy is characterized by vascular necrosis of small and medium-sized vessels.

References

  1. ↑ Guillevin L, Durand-Gasselin B, Cevallos R, Gayraud M, Lhote F, Callard P, Amouroux J, Casassus P, Jarrousse B (March 1999). "Microscopic polyangiitis: clinical and laboratory findings in eighty-five patients". Arthritis Rheum. 42 (3): 421–30. doi:10.1002/1529-0131(199904)42:3<421::AID-ANR5>3.0.CO;2-6. PMID 10088763.
  2. ↑ Hagen EC, Daha MR, Hermans J, Andrassy K, Csernok E, Gaskin G, Lesavre P, Lüdemann J, Rasmussen N, Sinico RA, Wiik A, van der Woude FJ (March 1998). "Diagnostic value of standardized assays for anti-neutrophil cytoplasmic antibodies in idiopathic systemic vasculitis. EC/BCR Project for ANCA Assay Standardization". Kidney Int. 53 (3): 743–53. doi:10.1046/j.1523-1755.1998.00807.x. PMID 9507222.
  3. ↑ Lhote F, Cohen P, Généreau T, Gayraud M, Guillevin L (1996). "Microscopic polyangiitis: clinical aspects and treatment". Ann Med Interne (Paris). 147 (3): 165–77. PMID 8796093.
  4. ↑ Savige J, Pollock W, Trevisin M (April 2005). "What do antineutrophil cytoplasmic antibodies (ANCA) tell us?". Best Pract Res Clin Rheumatol. 19 (2): 263–76. doi:10.1016/j.berh.2004.10.003. PMID 15857795.
  5. ↑ Okura T, Miyoshi K, Jotoku M, Enomoto D, Irita J, Nagao T, Ito R, Higaki J (2011). "A patient with myeloperoxidase antineutrophil cytoplasmic antibody-positive polyangiitis who developed sensorineural hearing loss and scleritis". Intern. Med. 50 (16): 1725–8. PMID 21841333.
  6. ↑ Guillevin L, Durand-Gasselin B, Cevallos R, Gayraud M, Lhote F, Callard P, Amouroux J, Casassus P, Jarrousse B (March 1999). "Microscopic polyangiitis: clinical and laboratory findings in eighty-five patients". Arthritis Rheum. 42 (3): 421–30. doi:10.1002/1529-0131(199904)42:3<421::AID-ANR5>3.0.CO;2-6. PMID 10088763.
  7. ↑ Schnabel A, Holl-Ulrich K, Dalhoff K, Reuter M, Gross WL (December 1997). "Efficacy of transbronchial biopsy in pulmonary vaculitides". Eur. Respir. J. 10 (12): 2738–43. PMID 9493653.
  8. ↑ Lauque D, Cadranel J, Lazor R, Pourrat J, Ronco P, Guillevin L, Cordier JF (July 2000). "Microscopic polyangiitis with alveolar hemorrhage. A study of 29 cases and review of the literature. Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (GERM"O"P)". Medicine (Baltimore). 79 (4): 222–33. PMID 10941351.

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