ANCA相關(guān)性血管炎腎損害病理表現(xiàn)

1、anca相關(guān)性血管炎腎損害病理表現(xiàn),p-anca perinuclear pattern anti-myeloperoxidase mpo-anca,c-anca cytoplasmic pattern anti-proteinase 3 pr3-anca,anti-neutrophil cytoplasmic autoantibodies (anca),large vessel vasculitis giant cell arteritis takayasu arteritis medium vessel vasculitis polyarteritis nodosa kawasaki di

2、sease small vessel vasculitis anca-associated vasculitis（aasv） microscopic polyangiitis granulomatosis with polyangiitis (wegeners) eosinophilic granulomatosis with polyangiitis (churg-strauss) immune complex vasculitis anti-gbm disease iga vasculitis (henoch-schnlein) cryoglobulinemic vasculitis hy

3、pocomplementemic urticarial vasculitis (anti-c1q vasculitis) variable vessel vasculitis (cogans, behcets, etc.) single organ vasculitis (cutaneous svv, primary cns vasculitis, etc.) vasculitis associated with systemic diseases (e.g. rheumatoid, lupus, sarcoid, etc.) vasculitis associated with probab

4、le etiologies (e.g. hbv, hcv, drug, cancer, etc.),2011 chapel hill consensus conference vasculitis nomenclature,光鏡 腎小球 節(jié)段性毛細(xì)血管袢纖維素樣壞死 新月體性腎炎，多新舊不等 腎小動脈 10%-50%可有腎小球外小動脈纖維素樣壞死，部分可有中等動脈受累 腎間質(zhì)-小管 炎癥，偶見肉芽腫樣病變 偶見髓質(zhì)小管周圍炎 免疫病理和電鏡微量或陰性,anca相關(guān)小血管炎腎損害病理表現(xiàn),毛細(xì)血管袢纖維素樣壞死,新月體形成,細(xì)胞性新月體,纖維細(xì)胞性新月體,小動脈纖維素樣壞死,小葉間動脈纖維素樣壞死 腎間質(zhì)大量炎癥細(xì)胞浸潤,小動脈纖維素樣壞死,小葉間動脈纖維素樣壞死，內(nèi)膜水腫伴炎癥細(xì)胞浸潤腎間質(zhì)大量炎癥細(xì)胞浸潤,小動脈纖維素樣壞死,慢性化表現(xiàn)：小葉間動脈管腔內(nèi)水腫，炎癥細(xì)胞浸潤 血管腔內(nèi)膜和肌層均纖維化,小管間質(zhì)病變-炎細(xì)胞浸潤,小管間質(zhì)病變-炎細(xì)胞浸潤,小管間質(zhì)病變-炎細(xì)胞浸潤,小管間質(zhì)病變-壞死性肉芽腫形成,免疫熒光-寡免疫性,igg400,免疫熒光,左：纖維素樣壞死 右：從一個纖維素樣