Rapidly progressive glomerulonephritis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
==Physical examination== | ==Physical examination== | ||
===Appearance of the patient=== | ===Appearance of the patient=== | ||
* Patients with rapidly progressive glomerulonephritis usually appear ill. | * Patients with rapidly progressive glomerulonephritis usually appear ill. | ||
* Patient may appear pale due to anemia. | |||
===Vital signs=== | ===Vital signs=== | ||
| Line 21: | Line 21: | ||
* Most of patients with [[Anti-neutrophil cytoplasmic antibody|ANCA]] +ve shows gastrointestinal involvement<ref name="pmid15758841">{{cite journal |vauthors=Pagnoux C, Mahr A, Cohen P, Guillevin L |title=Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome, or rheumatoid arthritis-associated vasculitis |journal=Medicine (Baltimore) |volume=84 |issue=2 |pages=115–28 |date=March 2005 |pmid=15758841 |doi= |url=}}</ref> | * Most of patients with [[Anti-neutrophil cytoplasmic antibody|ANCA]] +ve shows gastrointestinal involvement<ref name="pmid15758841">{{cite journal |vauthors=Pagnoux C, Mahr A, Cohen P, Guillevin L |title=Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome, or rheumatoid arthritis-associated vasculitis |journal=Medicine (Baltimore) |volume=84 |issue=2 |pages=115–28 |date=March 2005 |pmid=15758841 |doi= |url=}}</ref> | ||
* [[Occult bleeding|Occult]] GI bleeding as a result of [[ulceration]] due to [[arteritis]] | * [[Occult bleeding|Occult]] GI bleeding as a result of [[ulceration]] due to [[arteritis]] | ||
* [[Pancreatitis]] may be present | * [[Pancreatitis]] may be present with following signs | ||
** Abdominal pain radiating to back | |||
** Fever | |||
** Tachycardia | |||
** weight loss | |||
** Steatorhea | |||
===Neuromuscular=== | ===Neuromuscular=== | ||
| Line 30: | Line 35: | ||
===Genitourinary === | ===Genitourinary === | ||
* [[Hematuria]] | * [[Hematuria]] | ||
* melling/odorless penile/vaginal discharge | |||
=== Neuromuscular === | |||
* Neuromuscular examination of patients with [disease name] is usually normal. | |||
* Patient is usually oriented to persons, place, and time. | |||
=== Extremities === | |||
* Pitting/non-pitting [[edema]] of the upper/lower extremities | |||
==References== | ==References== | ||
Revision as of 20:17, 30 July 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2] Nazia Fuad M.D.
Overview
Physical examination
Appearance of the patient
- Patients with rapidly progressive glomerulonephritis usually appear ill.
- Patient may appear pale due to anemia.
Vital signs
Skin
- Leukocytoclastic vasculitis[1]
- Erythematous nodules due to necrotizing arteritis
- Granulomatous cutaneous nodules in patients present with granulomatosis with polyangitis
Abdomen
- Most of patients with ANCA +ve shows gastrointestinal involvement[2]
- Occult GI bleeding as a result of ulceration due to arteritis
- Pancreatitis may be present with following signs
- Abdominal pain radiating to back
- Fever
- Tachycardia
- weight loss
- Steatorhea
Neuromuscular
- Mononeuritis multiplex in ANCA +ve patients[3]
- Arthritis
- Arthralgia
Genitourinary
- melling/odorless penile/vaginal discharge
Neuromuscular
- Neuromuscular examination of patients with [disease name] is usually normal.
- Patient is usually oriented to persons, place, and time.
Extremities
- Pitting/non-pitting edema of the upper/lower extremities
References
- ↑ Daoud MS, Gibson LE, DeRemee RA, Specks U, el-Azhary RA, Su WP (October 1994). "Cutaneous Wegener's granulomatosis: clinical, histopathologic, and immunopathologic features of thirty patients". J. Am. Acad. Dermatol. 31 (4): 605–12. PMID 8089286.
- ↑ Pagnoux C, Mahr A, Cohen P, Guillevin L (March 2005). "Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome, or rheumatoid arthritis-associated vasculitis". Medicine (Baltimore). 84 (2): 115–28. PMID 15758841.
- ↑ Anadure R, Narayanan C, Varadraj G, Nandeesh B (January 2017). "ANCA Associated Mononeuritis Multiplex with Overlap in Vasculitic Syndromes". J Clin Diagn Res. 11 (1): OD01–OD03. doi:10.7860/JCDR/2017/22252.9149. PMC 5324437. PMID 28273992.