Rapidly progressive glomerulonephritis physical examination: Difference between revisions
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=== Neuromuscular === | === Neuromuscular === | ||
* | * Mononeuritis multiplex is the most common nervous system manifestation of ANCA-associated disease | ||
* It is caused by inflammation of the epineural arteries and arterioles, which results in ischemia of the nerve tissue | |||
* Central nervous system disease can result from involvement of meningeal vessels and patient can present with generalized seizures | |||
* Nervous system involvement is present in 30% of patients with microscopic polyangiitis and 70% of patients with Churg-Strauss diseas | |||
* Patient is usually oriented to persons, place, and time. | * Patient is usually oriented to persons, place, and time. | ||
Revision as of 20:20, 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
- Mononeuritis multiplex is the most common nervous system manifestation of ANCA-associated disease
- It is caused by inflammation of the epineural arteries and arterioles, which results in ischemia of the nerve tissue
- Central nervous system disease can result from involvement of meningeal vessels and patient can present with generalized seizures
- Nervous system involvement is present in 30% of patients with microscopic polyangiitis and 70% of patients with Churg-Strauss diseas
- 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.