Treatment of vascularides without antineutrophil cytoplasmic autoantibodies

Renal involvement: Several types of vascularides without antineutrophil cyt oplasmic autoantibodies (ANCA) can affect the kidney. The most frequently e ncountered are small-vessel vascularides leading to glomerulonephritis: Goo dpasture's disease, lupus, and, most importantly, rheumatoid purpura and ty pe II mixed cryoglobulinemia secondary to hepatitis C. Medium-sized vessel vascularitis, such as occurs in polyarthritis nodosa, is exceptional and le ads to renal ischemia. Renal involvement in large-vessel vascularites is al so exceptional, e.g. temporal artery arteritis and Takayasu's syndrome. Therapy: Treatment must be adapted to the type of vascularides and also its class (small, medium, or large-vessel disease) and depends on the gravity of each individual patient's situation. A large range of treatments have be en proposed, but there is little solid evidence concerning efficacy.