Síndromes reno-pulmonares associadas a anticorpo anticitoplasma do neutrófilo
Palavras-chave:
ANCA, vasculite, granulomatose de Wegener, poliangeíte microscópica, síndrome de Churg-StraussResumo
A síndrome reno-pulmonar é caracterizada pela associação de
hemorragia alveolar e glomerulonefrite rapidamente progressiva
(GNRP), no contexto de doenças graves, frequentemente associadas a positividade sérica para o anticorpo anticitoplasma do
neutrófilo (ANCA). A granulomatose de Wegener (WG), a poliangeíte microscópica (MPA) e a síndrome de Churg-Strauss (CSS)
são entidades descritas como vasculites de pequenos vasos
fortemente associados a ANCA. A síndrome reno-pulmonar é a
manifestação clínica mais frequente da vasculite sistémica. O
diagnóstico de vasculite associada a ANCA baseia-se em manifestações clínicas, biopsia do órgão afectado e presença sérica
de ANCA. No entanto, a inclusão de ANCA no estabelecimento do
diagnóstico permanece controversa. A compreensão de pontos-chave na patogénese da vasculite associada a ANCA pode, sem
dúvida, levar a uma abordagem terapêutica mais eficaz.
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Referências
Barros MT, Barros RT. Vasculites: classificação, patogénese e tratamento. Rev Bras Alerg Imunopatol 1998;21(4):128-138.
Reumaux D, Duthilleul P, Roos D. Pathogenesis of Diseases Associated With Antineutrophil Cytoplasm Autoantibodies. Human Immunology
;65:1-12.
Bosch X, Guilabert A, Font J. Antineutrophil cytoplasmic antibodies. Lancet 2006;368:404-418.
Griffith ME, Pusey CD. HLA genes in ANCA-associated vasculitides. Exp Clin Immunogenet 1997; 14(3):196-205.
Csernok E, Trabandt A, Gross WL. Immunogenetic aspects of ANCA associated vasculitides. Exp Clin Immunogenet. 1997, 14(3):177-182.
Borgmann S, Haubitz M. Genetic impact of pathogenesis and prognosis of ANCA-associated vasculitides. Clin Exp Rheumatology 2004; 22:79-86.
Frankel SK, Cosgrove GP, Fischer A, Meehan RT, Brown KK. Update in the diagnosis and management of pulmonary vasculitis. Chest 2006;129:452-465.
Thickett DR, Richter AG, Nathani N, Perkins GD, Harper L. Pulmonary manifestations of ANCA-positive vasculitis. Reumatology 2006;45:261-268.
Lohrmann Christian, Markus Uhl, Elmar Kotter, Dieter Burger, Nadir Ghanem, Mathias Langer. Pulmonary manifestations of Wegener granulomatosis: CT findings in 57 patients and review of the literature. European Journal of Radiology 2005; 53:471-477.
Mubashir E, Ahmed MM, Hayat S, Latif S, Heidmann M, Berney SM. Wegener granulomatosis: a case report and update. South Med J 2006;
(9):977-988.
Leavitt RY, Fauci AS, Bloch DA, Michel BA, Hunder GG, Arend WP, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener´s granulomatosis. Arthritis Rheum 1990; 33:1101-1107.
Ponniach I, Shaheen A, Shankar KA, Kumaran MG. Wegener´s granulomatosis: The current understanding. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:265-270.
Guillevin L, Durand-Gasselin B, Cevallos R, et al. Microscopic polyangiitis, clinical and laboratory finding in eighty-five patients. Arthritis and Rheumatism 1999; 42:421-430.
Jennette JC, Thomas DB, Falk RJ. Microscopic polyangiitis (microscopic polyarteritis). Semin Diagn Pathol 2001;18(1):3-13.
Agard C, Mouthon L, Mahr A and Guillevin L. Microscopic polyangiitis and polyarteritis nodosa: how and when do they start? Arthritis and Rheumatism 2003, 49: 709-715.
Santos JW, Trindade G, Pereira CE et al. Poliangeite microscópica com hemorragia alveolar difusa. J. Bras Pneumol 2004;30:150-153.
Sample D, Keogh J. Clinical review: Vasculitis on the intensive care unit. Critical Care 2005;9:193-197.
Hellmich B, Gross WL. Recent progress in the pharmacotherapy of Churg - Strauss Syndrome. Review. Expert Opin. Pharmacotherapy 2004; 5:25-35.
Keogh K, Specks U. Churg - Strauss Syndrome. Semin Resp Crit Care Med 2006;27:148-157.
Magalhães E, Tavares B, Chieira C. Pneumonias eosinofílicas. Rev Port Imunoalergologia 2006;14(3):196-217.
Cottin V, Cordier JF. Eosinophilic pneumonias. Allergy 2005;60:841-857.
Masi AT, Hunder GG, Lie JT, Michel BA et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis and Rheumatism 1990; 33:1094-1100.
Pierson DJ. Respiratory Considerations in Patient With Renal Failure. Respiratory Care 2006; 51:413-421.
Ward MM. Clinical Epidemiology: Diagnostic and Prognostic Tests. Curr Opin Rheumatol 2003;15 (2):104-109.
Schmitt WH; Woude FJ. Clinical applications of Antineutrophil Cytoplasmic Antibody Testing. Curr Opin Reumatology 2004;16(1):9-17.
Stone JH, Talor M, Stebbing J et al. Test characteristics of immunofluorence and ELISA tests in 856 consecutive patients with possible ANCA-associated conditions. Artritis Care Res 2000; 13 (6):424-434.
McLaren JS, Stimson RH, McRorie ER, Coia JE, Luqmani RA. The diagnostic value of anti-neutrophil cytoplasmic antibody testing in a routine clinical setting. QJM 2001; 94(11):615-621.
Mandl LA, Solomon DH, Smith EL, Lew RA, Katz JN, Shmerling RH. Using antineutrophil cytoplasmic antibody testing to diagnose vasculitis:
can test-ordering guidelines improve diagnostic accuracy? Arch Intern Med 2002;162(13):1509-1514.
Guillevin L, Cohen P, Mahr A et al. Treatment of polyarteritis nodosa and microscopic polyangiitis with poor prognosis factors: a prospective trial comparing glucocorticoids and six or twelve cyclophosphamide pulses in sixty five patients. Arthritis and Rheumatism 2003;49:93-100.
Seneghini CC, Freitas BB, Nagato RM et al. Hemorragia Alveolar - desafio clínico? Revista da SOCERJ 2005;18:269-271
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