Rapidly progressive glomerulonephritis physical examination

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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

The physical examination results are usually normal. Hypertension can be present but is not common. When organs or systems are affected, they reveal different findings, which include leukocytoclastic vasculitis, erythematous nodules due to necrotizing arteritis in skin.Patients may present with GI bleeding and pancreatitis. Other possible signs are arthritis and hematuria.

Physical examination

Appearance of the patient

Patients with rapidly progressive glomerulonephritis usually appear ill.

Vital signs

Hypertension

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

Neuromuscular

Mononeuritis multiplex in ANCA +ve patients^[3]
Arthritis
Arthralgia

Genitourinary

Hematuria

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.

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[pmid8089286-1] 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.

[pmid15758841-2] 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.

[pmid28273992-3] 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.

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