Microscopic polyarteritis

Microscopic polyarteritis is a necrotizing vasculitis with damage to small-caliber vessels, associated with antineutrophil cytoplasmic autoantibodies (ANCA); it is widespread with damage to many organs and systems, but the most pronounced changes are observed in the lungs, kidneys and skin. It has been identified as a separate nosological form of systemic vasculitis in recent years and included in the 1992 classification.

Symptoms. The disease begins with non-specific manifestations in the form of fever, intoxication, general weakness, articular syndrome, myalgia. Weight loss is noted. Lung damage is characterized by necrotizing alveolitis, often accompanied by pulmonary hemorrhage. Kidney damage is in the form of rapidly progressing glomerulonephritis. Ulcerative hemorrhagic vasculitis is observed on the skin.

Laboratory diagnostics.In 90% of patients, ANCA are detected, which are equally specific for serine proteinase-3 and myeloperoxidase, components of the primary granules of the neutrophil cytoplasm, and are a highly specific marker of microscopic polyarteritis.

Treatment.Prednisolone 1-2 mg/kg/day. In case of high process activity and pronounced visceritis - cyclophosphamide 2-3 mg/kg/day daily or pulse therapy 10-15 mg/kg once a month for at least 1 year. Antiplatelet agents, angioprotectors.

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