Q.170. What are the clinical manifestations & diagnosis of W.G. and M.P.?
Revise please the abbreviation list on:
https://draft.blogger.com/u/0/blog/post/edit/8610857019469578230/4564412989605988372
Vascular diseases and Vasculitis
Q.170. What are the clinical manifestations & diagnosis
of W.G. and M.P.?
A. Pulm. dis.: All ptns é W.G present é upper airway/pulm. involv. & majority hv both. One 1/3rd é pulm. involv.: aSmtic. Pulm. involv.
also occ. é MPA. The most common manif.:F[hemoptysis, pulm. hge & pleuritis and/or pl.
eff.].
Renal dis.: in WG & MPA manf. By [ARF + hematuria, RBCs
casts + Prot.]. R.
biopsy: segmental NGN. é few or no immune deposits (pauci-immune)
on I.F. & E/M. Crescents: commnly occ. & almost all pauci-immune CGN. ANCA-+ve. (96
%). ANCA- -ve, pauci-immune CGN= Part of this spectrum & hv similar R. biopsy
& prognosis, but there’s diff. in C.P., G. involving usually accompied by mononuclear T.I. infiltrates.
However, some ptns present é T.I.
+/- granuloma in abs. of typical G. les., but later on hs classic pauci-immune NGN.
R.-limited
vasculitis: Alth.
pauci-immune NGN. typically occ. é
affection of other organs in WG/MPA,
some ptns present é R-limited, ANCA-+ve(80 % MPO-ANCA) vasculitis. R.-limited
vasc. is considered a part of WG/MPA spectrum. bec. histp. finding in kidney are indistinguishble fr. those in WG
&MPA, some ptns usally develop extrarenal
manif. of WG or MPA . R.-limited vasc. tend to hv more G. sclerosis on R.
biopsy thn those é WG,
bec. ptns é R.-limited dis. present later due to abs. of extrarenal manifestation. Limited
form é clinical finding isolated to upper resp. or lungs, occ.
in 1/4th of cases. Alth. many (80%)
dev. G.N., there’re incompletly understood phenolltypic
diff. in WG. esp, ptns é limited dis. are younger at dis. onset, and more likely to be women. Despite younger at onset, ptns é limited dis. hv longer
dis. dur. thn ptns é sev. dis. & hv greater likelihood of hv.
ch.recurr.
dis.. It’s also hv higher prevelence of destructive upper resp. dis. (e.g, saddle-nose), but less
likely to be
Q.171.What are the most common Sm. of W.G. & M.P.?
A. The most
comm. Sm.:[persistent rhinorrhea, purulent/bldy
nasal disch., oral and/or nasal
ulcers, polyarthralgias, myalgias, or sinus pain]. Less cmm.: upper airway Sm.:[hoarseness, stridor, earache, conductive &
sensorineural hear-ing loss, otorrhea]. Lower resp. Sm. incl. [Cough,
dyspnea, hemoptysis (alv. Cpll. necrotic, or endobronchial dis.) & pleuritic pain]. Sm. cn be ass. é Sn. of pulm. cons-olidation and/or pl. effusion. Pulm. Sm. é abs. of upper resp.
Sm./Sn are unusual.
“Chest x-ray” find., incl. one or more of: