RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS DU RING MACROSCOPIC POLYARTERITIS-NODOSA - 7 CASES

Rapidly progressive glomerulonephritis (RPGN) is rarely associated wit h macroscopic polyarteritis nodosa (pAN), as seen in this series of 7 out of 235 patients. The clinical symptoms of PAN were as follows : my algias 6 ; fever 1 ; arthralgias and mononeuropathy multiplex 5 ; cuta neous vasculitis 3 ; arterial hypertension 4, 3 of which malignant. Th e mean protein was 2.7 g/24 h ; creatininemia 458 muM/l ; microscopic hematuria was present in 4 of the 7 patients only 1 patient was anuric . Markers of hepatitis B virus were absent in all cases. Arteriography revealed microaneurysms and renal infarcts in 6 patients and distal a rterial stenosis in one. Renal biopsies from all 7 patients demonstrat ed extracapillary glomerulonephritis, which was associated with tubulo interstitial fibrosis in one. Necrotizing vasculitis lesions were asso ciated in 5 cases. Immunofluorescence was positive in 5 cases. The ass ociation of RPGN and PAN exists and may be underestimated due to the l ack of systematic angiographic examinations during RPGN and renal biop sies in PAN patients with renal involvement.