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Medicine

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Rheumatology

Question
36 out of 50
 

Which of the following features may be used to distinguish PAN from microscopic Polyangiitis?



A ANCA positivity
B RBC cast in urine

C HBV infection
D All of the above

Ans. D All of the above

Microscopic polyangiitis (microscopic polyarteritis) (Ref: H-18th edition, Pg-2793)

i. Necrotizing vasculitis with no immune deposits affecting small vessels (i.e. capillaries, venules, or arterioles).

ii. Necrotizing arteritis involving small and medium-sized arteries may be present.

iii. Necrotizing glomerulonephritis is common.

iv. Pulmonary capillaritis often occurs.

Renal involvement in microscopic polyangiitis

i. Pathology in kidney is that of glomerulonephritis ii. Rapid renal impairment is characteristic

iii. Hypertension is infrequent.

Extra Edge:: Differences between PAN & MPA

Clinical features

PAN

MPA

Kidney involvement

i. Renal vasculitis with infarcts and microaneurysms

ii. RPGN

Yes

No

No

Yes

Lung involvement

Alveolar hemorrhage

No

Yes

Laboratory data

i. HBV – infection

ii. ANCA

Yes (10%)

Negative

No

Positive (p-ANCA)

i. Abnormal angiogram with microaneurysms

ii. Histology

iii. Relapses

Yes

Necrotizing vasculitis

Rare

No

Necrotizing vasculitis (No granulomas)

Common

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