Mycophenolate mofetil treatment in two children with severe polyarteritis nodosa refractory to immunosuppressant drugs

Falcini, Fabio; Serena, Capannini; Giustina, Russo; Battagliese, Antonella; D’Amico, Alessandra; Alessio, Maria

doi:10.1007/s00296-011-2003-y

Cited by 10 publications

(5 citation statements)

References 15 publications

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“… 18 , 19 Corticosteroids were the cornerstone therapies for these patients. As reported by Fernanda et al, 20 mycophenolate mofetil therapy is effective in patients refractory to corticosteroids. Cutaneous polyarteritis was rare and all patients presented with livedo reticularis or subcutaneous nodules.…”

Section: Discussionmentioning

confidence: 71%

Incidence and clinical features of paediatric vasculitis in Eastern China: 14-year retrospective study, 1999–2013

et al. 2016

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ObjectivesTo determine the incidence and clinical features of paediatric primary vasculitis in patients from one centre in Eastern China.MethodsMedical records of paediatric patients diagnosed with primary vasculitis between January 1999 and December 2013 were retrospectively reviewed. For Henoch–Schönlein purpura (HSP) and Kawasaki disease (KD), patients included in the analyses had data available for the previous 5 years.ResultsIn total, 1896 patients were identified, of whom 1100 had HSP, 760 had KD, 23 had Takayasu arteritis, five had polyarteritis nodosa, four had cutaneous polyarteritis, three had Behçet’s disease and one had microscopic polyangiitis. Of the 615 patients with HSP included in the analyses, 49.8% had HSP nephritis (for 90% of whom it occurred within 1 week of disease onset). Of the 470 patients with KD included in the analyses, 13.8% were diagnosed with incomplete KD and 29.0% had a concurrent coronary artery lesion. For the 23 patients with Takayasu arteritis, the common clinical symptoms were hypertension, asphygmia/weak pulse and heart failure; only one of these patients had been diagnosed at an early disease stage. The five patients with polyarteritis nodosa received immunosuppressant therapy following diagnosis. Other vasculitides were uncommon.ConclusionsThe most common primary vasculitides in this population of children from Eastern China were HSP and KD; other vasculitides were rare. Paediatricians should be suspicious of vasculitis when there is evidence of systemic inflammation and multisystem disease that cannot be explained by one specific disorder.

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Section: Discussionmentioning

confidence: 71%

Incidence and clinical features of paediatric vasculitis in Eastern China: 14-year retrospective study, 1999–2013

et al. 2016

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“…Successful treatment with anti-TNF-a agents or RTX has been reported [64,65]. Two cases of refractory PAN that responded to MMF have also been reported [66]. The role of aspirin in the treatment of PAN has not been well studied; however, it is commonly prescribed at antiplatelet doses for its antithrombotic effect [64].…”

Section: Polyarteritis Nodosa and Cutaneous Polyarteritis Nodosamentioning

confidence: 96%

Pediatric vasculitis

Morishita

Brown

Cabral

2015

Current Opinion in Rheumatology

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“…Dies sollte jedoch aufgrund einer widersprüchlichen Datenlage in Abhängigkeit von der Schwere der Erkrankung und möglichen Risiken bzw. Nebenwirkungen sorgfältig abgewogen werden [132].…”

Section: Mit Hepatitis-b-virus Assoziierte Nierenerkrankungenunclassified

Ursachen der chronischen Nierenschädigung in Patienten mit Lebererkrankungen – Pathophysiologie und Therapiemöglichkeiten

et al. 2021

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ZusammenfassungEine akute oder chronische Nierenschädigung bei gleichzeitig bestehender Lebererkrankung stellt ein häufiges Problem dar und geht im weiteren klinischen Verlauf mit zahlreichen Komplikationen sowie einer gesteigerten Dialysepflichtigkeit und Mortalität einher.Die Prävalenz einer chronischen Niereninsuffizienz (CNI) bei Patienten mit Lebererkrankungen ist hoch, nicht zuletzt wegen parallel bestehender Komorbiditäten (z. B. metabolisches Syndrom, chronische Entzündungsprozesse, Hyperkoagulabilität, Hyperfibrinolyse, Diabetes mellitus, Dyslipidämie usw.). Doch nicht jede chronische Verschlechterung der Nierenretentionsparameter lässt sich auf ein hepatorenales Syndrom zurückführen. Neben diesem sind die häufigsten Ursachen der CNI bei bestehenden Lebererkrankungen die diabetische Nephropathie, die alkoholassoziierte IgA-Nephropathie, die mit Hepatitis C assoziierte membranoproliferative Glomerulonephritis und die mit Hepatitis B assoziierte membranöse Glomerulonephritis.Koexistente Erkrankungen, ähnlich bzw. parallel ablaufende pathophysiologische Mechanismen und überlappende Erscheinungsbilder stellen hinsichtlich der Ursachenfindung und entsprechenden Behandlung der CNI im Rahmen einer existenten Lebererkrankung eine Herausforderung an den Kliniker dar. Diese Übersichtsarbeit skizziert sowohl häufige als auch seltene Entitäten, die zu einer chronischen Nierenschädigung in diesem speziellen Patientenkollektiv führen, und zeigt einen Überblick zu therapeutischen Möglichkeiten.

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Mycophenolate mofetil treatment in two children with severe polyarteritis nodosa refractory to immunosuppressant drugs

Cited by 10 publications

References 15 publications

Incidence and clinical features of paediatric vasculitis in Eastern China: 14-year retrospective study, 1999–2013

Incidence and clinical features of paediatric vasculitis in Eastern China: 14-year retrospective study, 1999–2013

Pediatric vasculitis

Ursachen der chronischen Nierenschädigung in Patienten mit Lebererkrankungen – Pathophysiologie und Therapiemöglichkeiten

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