Lökositoklastik Vaskülit Olarak Gelen Bir Olguda Nefrotik Sendrom Nedeni: Fokal Segmental Glomerüloskleroz

Year 2014, Volume: 15 Issue: 3, 118 - 200, 01.12.2014

Abdülkerim Furkan Tamer Habib Emre Levent Korkmaz Erim Gülcan Refik Ali Sarı Abdullah Uyanık Mustafa Keleş

Abstract

Lökositoklastik vaskulit vücuttaki küçük damarların inflamasyonu anlamına gelmektedir. Genellikle ciltte özellikle bacaklarda belirti verir ancak vücudun diğer bölgelerinde de ortaya çıkabilir. Klinik pratikte en yaygın görülen vaskulittir. Lökositoklastik vaskulit pek çok nefrolojik hastalıklarla birlikte seyredebilir. Ancak lökositoklastik vaskulit olarak gelen nefrotik sendromlu hastada fokal segmental glomerüloskleroz görülmesi beklenmeyen bir durumdur. Fokal segmental glomerülosklerozda glomerüler hasara ve glomerüloskleroza yol açan etyolojik ajanlar veya mekanizmaların çoğu bilinmemektedir. Onsekiz yaşında her iki üst ve alt ekstremitelerde döküntü ve kızarıklık, her iki bacaklarda şişlik şikayetleri ile kliniğimize başvuran hastaya lökositoklastik vaskulit tanısı konuldu. Nefrotik düzeyde proteinürisi olan hastanın böbrek biyopsisinde ise fokal segmental glomeruloskleroz tespit edildi

Keywords

: Fokal segmental glomerüloskleroz, lökositoklastik vaskulit, nefrotik sendrom

Cause of Nephrotıc Syndrome at A Case Admitted About Leukocytoclastic Vasculitis: Focal Segmental Glomerulosclerosis

Abstract

Leukocytoclastic vasculitis refers to the inflammation of small blood vessels in the body. It usually manifests in the skin, particularly in the legs, but it may also occur in other areas. It is the most common vasculitis seen in clinical practice. Leukocytoclastic vasculitis can progress together with many nephrological diseases. However, focal segmental glomerulosclerosis is unexpected cause of nephrotic syndrome at a case admitted about leukocytoclastic vasculitis. Etiologic agents or mechanisms that initiate glomerular injury and lead to glomerulosclerosis are largely unknown in focal segmental glomerulosclerosis. An eighteen years old patient who presented to our clinic with skin eruption and rushes of both lower and upper extremities and edema of lower extermities had been diagnosed leukocytoclastic vasculitis. The patient with nephrotic range proteinuria, renal biopsy reveal.

Keywords

Focal segmental glomerulosclerosis, leukocytoclastic vasculitis, nephrotic syndrome

References

• 1. Wasserman AM, Sarantopoulos GP, Khanna D. Fungal Leukocytoclastic Vasculitis as a Presentation of Systemic Vasculitis in a Patient With Systemic Lupus Erythematosus. J Clin Rheumatol 2009; 15: 383-6. [CrossRef]
• 2. Kim JH, Moon JI, Kim JE, Choi GS, Park HS, Ye YM, Yim H. Cutaneous leukocytoclastic vasculitis due to anti-tuberculosis medications, rifampin and pyrazinamide. Allergy Asthma Immunol Res 2010; 2: 55-8. [CrossRef]
• 3. Apel GB. Glomerular Disorders. In: Goldman L, Ausiello D: Cecil textbook of medicine (22nd ed). Global Medicine publ, USA, 2004; 726-28.
• 4. Carlson JA. The histological assessment of cutaneous vasculitis. Histopathology 2010; 56: 3-23. [CrossRef]
• 5. Kawakamı T. New algorithm (KAWAKAMI algorithm) to diagnose primary cutaneous vasculitis. Journal of Dermatology 2010; 37: 113-24. [CrossRef]
• 6. Yoshioka K, Takemura T, Murakami K, ve ark. Transforming growth factor-beta protein and mRNA in glomeruli in normal and diseased human kidneys. Lab Invest 1993; 68: 154-63.
• 7. Tsai TC, Chen CY, Lin WT, Lee WJ, Chen HC. Sjogren’s SyndromSyndrome e Complicated with IgA Nephropathy and Leukocytoclastic Vasculitis. Ren Fail 2008; 30: 755-8. [CrossRef]
• 8. Engel F, Maradeix S, Braun-Parvez L, Lipsker D, Cribier B. Leukocytoclastic vasculitis with severe renal involvement following Parvovirus B19 primary infection. Ann Dermatol Venereol 2007; 134: 160-3. [CrossRef]
• 9. Yanai-Berar N, Ben-Itzhak O, Gree J, Nakhoul F. Influenza vaccination induced leukocytoclastic vasculitis and pauci-immune crescentic glomerulonephritis. Clin Nephrol 2002; 58: 220-3. [CrossRef]
• 10. Saekia T, Uenob M, Shimadab H, ve ark. Membranoproliferative glomerulonephritis associated with hypocomplementemic urticarial vasculitis after complete remission of membranous nephropathy. Nephron 2001; 88: 174-7. [CrossRef]
• 11. Mandhadi R, Kodumuri V, Arora R, Singh PP, Adigopula S, Chua S. A Case of palpable purpura and nephropathy: Occam’s Razor or Hickam’s Dictum. Am J Ther 2011; 20: 572-5. [CrossRef]