Nefro - 22-2.indd

نویسندگان

  • Manuel Heras
  • María José Fernández-Reyes
  • Rosa Sánchez
  • Ana Saiz
  • Alvaro Molina
  • Carmen Mon
  • Elena Ciruelo
  • Eva Tomero
  • Fernando Alvarez-Ude
چکیده

Pauci -immune necrotising glomerulonephritis with extracapillary proliferation is a common renal histological manifestation of systemic vasculitis. Although its aetiopathogenesis is not well known, it is possible that environmental factors may have a bearing on genetically predisposed subjects, since there are many familial cases of systemic vasculitis. The frequent association between systemic vasculitis and ANCAs suggests autoimmune mechanisms play a part in its pathogenesis. We report two cases of necrotising extracapillary proliferative glomerulonephritis in two siblings sharing the same environment. We do not know if the first case had ANCAs, meaning the role of the autoimmune mechanism is not clear (diagnosis was made in 1988 when it was not possible to measure ANCAs in this hospital). Since the second case had the same kind of illness associated to positive ANCAs and autoimmune hypothyroidism, we presume that both siblings presented the same pathogenesis. These two cases of familial vasculitis appear to support the hypothesis that environmental, genetic and autoimmune factors influence the pathogenesis of systemic vasculitis. Key -Words: ANCA; familial systemic vasculitis; necrotising glomerulonephritis. INTRODUCTION Pauci -immune necrotising glomerulonephritis (PING) with extracapillary proliferation is the renal anatomopathological expression of systemic vasculitis. This disease typically affects small to medium -size blood vessels and is commonly associated with the presence of antineutrophil cytoplasmic antibodies (ANCAs)1. The pathogenesis of systemic vasculitis is unknown, although it involves genetic and environmental factors2,3. The literature describes different associations of familial vasculitis4,5. We report the presence of necrotising glomerulonephritis in two siblings.

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تاریخ انتشار 2008