“Vasculitis de pequeños vasos con afectación renal”

Abstract

Vasculitis is a group of systemic diseases characterized by inflammation of the blood vessels, thus determining the deterioration or obstruction of normal blood flow and damage to the integrity of the vascular wall. They can affect any type of vessel of the organism and the compromise can be of one or several organs or systems. The caliber of the blood vessel that can compromise, goes from great arteries (aorta and its main branches, temporal arteries); Medium vessels (muscular arteries); and small vessels (arterioles, capillaries and venules). Vasculitis associated with antibodies to neutrophil cytoplasm (ANCA) causes renal dysfunction predominantly due to severe inflammation with the presence of cellular growths in the glomeruli. The clinical manifestation of these diseases is due to the expression of ischemia in the tissues of the involved vessels, in addition to presenting fever, weight loss and general compromise of the state that frequently accompany systemic inflammation. The diagnosis is based on clinical manifestations, immunological studies and renal biopsy. The vast majority of patients with ANCA-associated vasculitis reach the control of the disease with immunosuppressive therapy, being important to perform an early onset in order to better the evolution and avoid complications. We present the case of an elderly male patient, with no significant pathological history. It is present for a three-month course of evolution due to anesthesia, anorexia, nausea that does not reach vomit and headache, a hospital center where it is attended to and shows microscopic hematuria plus leukocyturia, is interpreted as a urinary infection and starts treatment Antibiotic, As they have not improved the performance of laboratory tests in which they observe high azoles, and cataloging as a chronic kidney disease, so they decide to make a referral to a level II hospital, to the external consultation area of Nephrology. Patient due to its systemic manifestations, active urinary sediment in the absence of urinary infection and renal dysfunction of unaffiliated cause is suspected in an immunological disease with renal involvement, indicating immunological studies of antineutrophil cytoplasmic antibodies (ANCA) with a perinuclear pattern ANCA-P) positive, orienting towards vasculitis of small ANCA positive vessels.