Incidência de tromboembolismo venoso fatal em vasculite associada a anticorpo anticitoplasma de neutrófilos

Santana, Alfredo Nicodemos Cruz; Takagaki, Teresa Yae; Barbas, Carmen Sílvia Valente

doi:10.1590/s1806-37132011000300019

Cited by 4 publications

(5 citation statements)

References 9 publications

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“…Thrombosis of mesenteric vessels is a rare manifestation of VTE in AAV patients [3], [4], [5], [6]. The patient in our case developed acute mesenteric ischemia resulting in emergent laparotomy and resection of the majority of his small bowel.…”

Section: Discussionmentioning

confidence: 72%

“…The increased VTE risk ranged between 1.8/100–7/100 person-years compared to 0.3/100 person-years in the healthy population [4], [5], [6]. It is important to remember that while hemoptysis may represent DAH, it could also be a sign of a PE [6]. Increased VTE risk in AAV patients is likely attributed to cytokines, ischemia, and ANCA which play a role in thrombosis from endothelial damage and inflammation [4], [6].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have looked at the increased risk of VTE in AAV patients while accounting for more classic VTE risk factors (immobilization, trauma, surgery, malignancy, pregnancy, oral contraception/hormone replacement, smoking, atrial fibrillation, family history, obesity, and thrombophilia) [4], [5], [6]. The increased VTE risk ranged between 1.8/100–7/100 person-years compared to 0.3/100 person-years in the healthy population [4], [5], [6]. It is important to remember that while hemoptysis may represent DAH, it could also be a sign of a PE [6].…”

Section: Discussionmentioning

confidence: 99%

“…It is important to remember that while hemoptysis may represent DAH, it could also be a sign of a PE [6]. Increased VTE risk in AAV patients is likely attributed to cytokines, ischemia, and ANCA which play a role in thrombosis from endothelial damage and inflammation [4], [6]. Cyclophosphamide and high dose steroids may also contribute to thrombosis [4].…”

Section: Discussionmentioning

confidence: 99%

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Microscopic polyangiitis: Atypical presentation with extensive small bowel necrosis, diffuse alveolar hemorrhage, and renal failure

Segraves

Iyer

2017

Respiratory Medicine Case Reports

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Microscopic polyangiitis is an uncommon systemic vasculitis of varying severity that is associated with myeloperoxidase (MPO) and perinuclear antineutrophil cytoplasmic (p-ANCA) antibodies. The most commonly affected organs are the lungs and kidneys. We report on a very unusual case of microscopic polyangiitis presenting with severe mesenteric ischemia in addition to diffuse alveolar hemorrhage and acute renal failure. The patient was initially diagnosed with acute pancreatitis at an outside facility given his severe abdominal pain and elevated pancreatic enzymes. Further investigations after transfer to our facility determined that the patient was actually suffering from a severe exacerbation of previously diagnosed microscopic polyangiitis. He quickly developed diffuse alveolar hemorrhage (DAH) necessitating intubation and acute kidney injury (AKI) requiring dialysis. He subsequently developed mesenteric ischemia and bowel necrosis resulting in emergent laparotomy and extensive small bowel resection. Physicians need to be aware that microscopic polyangiitis can very rarely present with severe involvement of the abdominal viscera and mesenteric vessels. Severe disease necessitates the use of high dose IV steroids, rituximab or cyclophosphamide, and plasma exchange (PLEX).

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Microscopic polyangiitis: Atypical presentation with extensive small bowel necrosis, diffuse alveolar hemorrhage, and renal failure

Segraves

Iyer

2017

Respiratory Medicine Case Reports

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“…Patients who have ANCA-associated vasculitis also have an increased risk of developing venous thromboembolism especially during the active phase of disease [18] .The increased risk has been hypothesized to result from endothelial changes and hypercoagulability caused by ANCA-vasculitis and its treatment [18–20] .…”

Section: Discussionmentioning

confidence: 99%

Microscopic polyangiitis associated with pleuropericarditis, pulmonary embolism and pulmonary hemorrhage as a complication of silicosis

Al-Rajhi

Brega

Colman

2015

Respiratory Medicine Case Reports

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Silica (silicon dioxide) occupational exposure has been linked to both pulmonary and extra-pulmonary toxicity. Silicosis is the major pulmonary toxicity, which has also been associated with the development of collagen-vascular disease and with anti-neutrophil cytoplasmic antibody (ANCA)-positive vasculitis, especially perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA). The most common pulmonary manifestations of microscopic polyangitis (MPA) are interstitial fibrosis and alveolar hemorrhage. We describe a patient who had unusual presentation of microscopic polyangitis, characterized by lung hemorrhage, rapidly progressive glomerulonephritis, pleuropericarditis and pulmonary embolism that was associated with a history of silica exposure and radiologic evidence for silicosis.

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Vasculitis with Thrombosis

Herold

2013

Sine Syndromes in Rheumatology

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Incidência de tromboembolismo venoso fatal em vasculite associada a anticorpo anticitoplasma de neutrófilos

Cited by 4 publications

References 9 publications

Microscopic polyangiitis: Atypical presentation with extensive small bowel necrosis, diffuse alveolar hemorrhage, and renal failure

Microscopic polyangiitis: Atypical presentation with extensive small bowel necrosis, diffuse alveolar hemorrhage, and renal failure

Microscopic polyangiitis associated with pleuropericarditis, pulmonary embolism and pulmonary hemorrhage as a complication of silicosis

Vasculitis with Thrombosis

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