Hemorrhagic complications associated with PR3-ANCA crescentic glomerulonephritis

Abstract

Hemorrhagic complications of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis are life-threatening conditions. Of these, alveolar hemorrhage is the most common and well-described hemorrhagic complication and is a prominent component of the pulmonary-renal syndrome. The clinical presentation of alveolar hemorrhage is highly variable ranging from mild to serious disease that may require respiratory support. Less attention has been directed at hemorrhagic complications that have been reported in other organs and which may be as severe or more severe with regard to morbidity and mortality. For example, among the most serious non-pulmonary complications are those related to cerebral and gastrointestinal hemorrhage. Cerebral hemorrhage is the clearly the most critical issue with a persistent high mortality rate. The prognosis of gastrointestinal hemorrhage, once an ominous complication has improved with medical and surgical intervention. Not to be dismissed are the consequences of hemorrhagic issues related to skin, soft tissue or muscle involvement. Muscle hematomas, while rare, also accompanied by significant morbidity.

• Alveolar hemorrhage
• anti-neutrophil cytoplasmic autoantibody
• crescentic glomerulonephritis
• gastrointestinal bleeding
• rectus muscle hematoma

Acknowledgments

We are very grateful to National Natural Science Foundation of China and Youth Science and Technology Excellence Project of China-Japan Friendship Hospital for the financial assistance.

Declaration of interest

Financial assistance was provided by National Natural Science Foundation of China [grant number 81200535] and Youth Science and Technology Excellence Project of China-Japan Friendship Hospital [Grant number: 2014-QNYC-A-01]. The authors declare no conflicts of interests. The authors alone are responsible for the content and writing of this article.