Medium-size-vessel vasculitis.

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Michael J DillonPaul A Brogan

Abstract

Medium-size-artery vasculitides do occur in childhood and manifest, in the main, as polyarteritis nodosa (PAN), cutaneous PAN and Kawasaki disease. Of these, PAN is the most serious, with high morbidity and not inconsequential mortality rates. New classification criteria for PAN have been validated that will have value in epidemiological studies and clinical trials. Renal involvement is common and recent therapeutic advances may result in improved treatment options. Cutaneous PAN is a milder disease characterised by periodic exacerbations and often associated with streptococcal infection. There is controversy as to whether this is a separate entity or part of the systemic PAN spectrum. Kawasaki disease is an acute self-limiting systemic vasculitis, the second commonest vasculitis in childhood and the commonest cause of childhood-acquired heart disease. Renal manifestations occur and include tubulointerstitial nephritis and renal failure. An infectious trigger and a genetic predisposition seem likely. Intravenous immunoglobulin (IV-Ig) and aspirin are effective therapeutically, but in resistant cases, either steroid or infliximab have a role. Greater understanding of the pathogenetic mechanisms involved in these three types of v...Continue Reading

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Citations

Nov 4, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Paul BroganMichael Dillon
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Jun 12, 2013·Arthritis and Rheumatism·Despina EleftheriouPaul A Brogan
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Methods Mentioned

BETA
biopsy
ESR

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