Polyarteritis nodosa presenting with spontaneous perirenal hematoma

Mukhopadhyay, Pinaki; Rathi, Manish; Kohli, Harbir Singh; Jha, Vivekanand; Gupta, KL; Sakhuja, Vinay

doi:10.4103/0971-4065.101254

Cited by 5 publications

(2 citation statements)

References 16 publications

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“…In a recent study done by Ghimire et al, MN was the most common pattern of glomerular disease. 2 FSGS was reported as the most common finding by Rathi et al 18 It's quite difficult to pinpoint the specific reason for the difference in the pattern of glomerular injury in different studies but one of the reasons we could speculate is that ours being the tertiary center located in the central part of the country would receive the varieties of cases from all over the country.…”

Section: Discussionmentioning

confidence: 86%

Clinico-Pathological Spectrum of Biopsy Proven Native Kidney Disease in a Tertiary Hospital in Nepal

Sedhain,

Karki,

Baral

et al. 2024

JCMC

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Background: Kidney biopsy has been regarded as an important tool for the diagnosis, management and monitoring the prognosis of renal diseases. We conducted this study to find out the clinico-pathological spectrum by native kidney biopsy in a relatively large scale. Methods: This was a hospital based, prospective, observational study carried out in a tertiary hospital of Kathmandu from January 2022 to December 2023. The biopsy specimens were reported by nephropathologists on the basis of light microscopy, direct immunofluorescence for all samples and electron microscopic examination whenever indicated. The patient`s demographic profile, indication and histological findings of kidney biopsy were studied and analyzed using appropriate statistical tools. Results: A total of 610 kidney biopsies were performed during the study period, of which 24 samples did not meet the inclusion criteria and 586 patients were included in the final analysis. The mean age of the patients was 42.08 ±9.09 years and 59.03% of the patients were younger than 40 years. Females outnumbered the males with female to male ratio of 1.09. The most common presentation was limb swelling (81.22%) and nephrotic syndrome was the most common indication for the biopsy and the most common histological finding was lupus nephritis, followed by IgA nephropathy and FSGS. Non-diabetic kidney disease was found in 54.28% of diabetic patients who underwent biopsy. Conclusions: Nephrotic syndrome was the most common indication for kidney biopsy with lupus nephritis being the most common histological finding. Non diabetic kidney disease (NDKD) was found in more than half of the patients with diabetes mellitus.

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Section: Discussionmentioning

confidence: 86%

Clinico-Pathological Spectrum of Biopsy Proven Native Kidney Disease in a Tertiary Hospital in Nepal

Sedhain,

Karki,

Baral

et al. 2024

JCMC

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“…Seventeen of 20 patients with PN treated for spontaneous perirenal hematomas required angioembolization or nephrectomy, whereas the other three were cured following conservative treatment (Table 2) [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Some of these patients may actually have had MPA.…”

Section: Discussionmentioning

confidence: 99%

Successful non-surgical treatment on bilateral spontaneous perirenal giant hematomas in rapidly progressive glomerulonephritis with MPO-ANCA positive

et al. 2015

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Background: Perirenal hematomas are most frequently caused by neoplasm, followed by polyarteritis nodosa (PN), but may also be a rare complication of MPA. Case Presentation: A 77-year-old woman who presented with rapidly progressive glomerulonephritis, proteinuria, and mononeuropathy multiplex, and was positive for serum myeloperoxidase-anti-neutrophil cytoplasmic antibody, was diagnosed with vasculitis as a probable microscopic polyangiitis (MPA). She developed a spontaneous right-sided perirenal hematoma, along with back pain, on the day of referral to the nephrology unit and a spontaneous left-sided perirenal hematoma ten days later. Treatment with 30 mg/day prednisolone stabilized the hematomas and controlled the progression of probable MPA. Conclusion: Nephrectomy or embolization is commonly required in patients with perirenal hematoma associated with neoplasm or PN, but radical invasive management may not be necessary in patients with MPA because smaller blood vessels are affected, resulting in less extensive bleeding and normal clotting. Accurate differential diagnosis between MPA and PN is essential to avoid invasive management of perirenal hematomas in patients with MPA. The presence of glomerulonephritis suggests injury to capillary vessels, a characteristic of MPA.

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Polyarteritis nodosa and microscopic polyangiitis – The Indian experience

Handa¹

2015

Indian Journal of Rheumatology

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Polyarteritis nodosa presenting with spontaneous perirenal hematoma

Cited by 5 publications

References 16 publications

Clinico-Pathological Spectrum of Biopsy Proven Native Kidney Disease in a Tertiary Hospital in Nepal

Clinico-Pathological Spectrum of Biopsy Proven Native Kidney Disease in a Tertiary Hospital in Nepal

Successful non-surgical treatment on bilateral spontaneous perirenal giant hematomas in rapidly progressive glomerulonephritis with MPO-ANCA positive

Polyarteritis nodosa and microscopic polyangiitis – The Indian experience

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