Microscopic polyangiitis overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]


The early case reports of Microscopic polyangiitis provide a historical context and foundation for better understanding of the current concepts of these diseases Microscopic polyangiitis.Microscopic polyangiitis was first introduced by Dr. Friedrich Wohlwill, a German neuropathologist, who described two patients with transmural periarteritis with glomerulonephritis in 1923.Historically, most forms of vasculitis like microscopic polyangiitis described subsequently classified on the basis of features similar to or distinct from polyarteritis.According to The International Chapel Hill Consensus Conference (CHCC) criteria based on Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) into granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), including renal-limited vasculitis (RLV), and eosinophilic granulomatosis with polyangiitis (EGPA, Churg-Strauss).The pathogenesis of Microscopic polyangiitis is currently not fully understood. However, certain hypothesizes have been made to determine possible factors that may trigger the disease such as environmental factors and anti-neutrophil cytoplasmic antibodies. Capillaries and venules are involved in the pathogenesis of microscopic polyangiitis.The paucity of immunoglobulin deposition is shown in Immunohistochemical staining.There are no known direct causes for Microscopic polyangiitis.Microscopic polyangiitis can affect individuals from all ethnicities and of any age group.Vasculitis is a common term that refers to inflammation of the blood vessels in the body.When the inflammation progress it lead to weakening and stretch of the blood vessels and forms a an aneurysm.Microscopic polyangiitis is not a cancer, not contagious, and it does not usually occur within families.The prevalence of Microscopic polyangiitis higher in Southern European countries and Asia.The incidence of GPA was similar to that of MPA.MPO‐ANCAs when positive in a patient was a marker of poor prognosis in the population of patients with AAV.Factors that are associated with the development of Microscopic polyangiitis is currently unknown. However, it has been suggested that environmental factors (silica exposure) may play a role.Currently, there are no screening protocols for Microscopic polyangiitis.If left untreated, Microscopic polyangiitis can progress to end stage renal failure and respiratory failure. Complications of Microscopic polyangiitis include, alveolar hemorrhage, end stage renal failure, osteoarticular disease, and infections. The prognosis of Microscopic polyangiitis. Obtaining a complete history is a critical aspect of making a clinical diagnosis of Microscopic polyangiitis.As it can help differentiate between the Antineutrophil cytoplasmic antibodies(ANCA) associated vasculitis and other possible causes that may mimic the disease. There are many similarities that are present between ANCA associated vasculitis and Microscopic polyangiitis. A history and clinical symptoms can help assess the disease. A complete medical history and comprehensive renal, pulmonary, and dermatological examination must be performed to help identify and properly diagnose Microscopic polyangiitis from other diseases.Obtaining a complete history is a critical aspect of making a clinical diagnosis of Microscopic polyangiitis.As it can help differentiate between the Antineutrophil cytoplasmic antibodies(ANCA) associated vasculitis and other possible causes that may mimic the disease. There are many similarities that are present between ANCA associated vasculitis and Microscopic polyangiitis. A history and clinical symptoms can help assess the disease.When suspecting a patient with microscopic polyangiitis(MPO) an ANCA test should be an idle choice.Laboratory findings consistent with the diagnosis of Microscopic polyangiitis include leukocytosis, elevated erythrocyte sedimentation rate, proteinuria, hematuria, red cell casts, elevated blood urea nitrogen, elevated serum creatinine, and anti-neutrophil cytoplasmic antibodies.There are no electrocardiogram findings associated with microscopic polyangiitis.An x-ray may be helpful in the diagnosis of Microscopic polyangiitis. Findings on an x-ray suggestive of Microscopic polyangiitis include diffuse, bilateral alveolar infiltrates.Chest CT scan may be helpful in the diagnosis of Microscopic polyangiitis. Findings on CT scan suggestive of/diagnostic of Microscopic polyangiitis include nodules, cavitation, and alveolar opacities,airway inflammation and stenotic lesions.Magnetic resonance imaging (MRI) is one of the most commonly used imaging modality in the workup of patients who are suspected to have cerebral vasculitis.Head MRI may be helpful in the diagnosis of microscopic polyangiitis. Findings on MRI suggestive of microscopic polyangiitis include cerebral hemorrhage and white matter lesions.Ultrasound may be helpful in the diagnosis of microscopic polyangiitis. Findings on an ultrasound suggestive of microscopic polyangiitis include determining disease extension and disease activity, evaluate renal, cardiac and pleural involvement.Ultrasound helps in detecting abnormalities that are pathognomonic in the arteries with a diameter below 1 mm in size.Microscopic polyangiitis responds well to treatment with glucocorticoids such as prednisone together with an immunosuppressant such as cyclophosphamide. The combination of these 2 drugs decreases the remission of Microscopic polyangiitis by about 90%.Surgery is not the first-line treatment option for patients with microscopic polyangiitis. Surgery is usually reserved for patients with either stenosing and destructive lesions of the nasal cartilage and bones of the patients who are suffering from microscopic polyangiitis.