Microscopic Polyangiitis Treatment & Management

  • Author: Mehran Farid-Moayer, MD; Chief Editor: Vecihi Batuman, MD, FACP, FASN   more...
 
Updated: Jan 24, 2012
 

Medical Care

  • Microscopic polyangiitis (MPA) can manifest as a mild systemic vasculitis with mild renal insufficiency, or it can manifest as a full blown acute disease with rapid deterioration of renal function and respiratory failure due to pulmonary capillaritis. Treatment depends on the extent of disease, the rate of progression, and the degree of inflammation (see Medication).
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Consultations

  • A rheumatologist would be the main consultant who helps with the diagnosis and immunosuppressive therapy.
  • Base consultations on the specific organ system involvement, as follows:
    • Consult a pulmonologist for the management of hemoptysis due to pulmonary alveolar capillaritis. Additionally, consult a pulmonologist to help with the management of respiratory failure associated with diffuse alveolar hemorrhage and with the diagnosis of pulmonary involvement.
    • Consult a nephrologist for help with the diagnosis and management of renal involvement and possible need for dialysis.
    • Consult a gastroenterologist, if necessary, for the management of gastrointestinal bleeding.
    • Consult a surgeon in cases involving catastrophic events in gastrointestinal or other organ systems.
    • Consult a hematologist if plasmapheresis is considered.
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Diet

  • The nutritional requirement depends on the particular clinical situation, such as renal failure, respiratory failure, or pancreatitis.
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Contributor Information and Disclosures
Author

Mehran Farid-Moayer, MD  Adjunct Clinical Faculty, Department of Psychiatry, Sleep Disorders Clinic, Stanford Medical Center

Mehran Farid-Moayer, MD is a member of the following medical societies: American Academy of Sleep Medicine, American Medical Association, and American Thoracic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Spencer T Lowe, MD  Rheumatologist, Private Practice, Peninsula Medical Group, Burlingame, CA

Spencer T Lowe, MD is a member of the following medical societies: American College of Rheumatology, California Medical Association, and International Society for Clinical Densitometry

Disclosure: Nothing to disclose.

Specialty Editor Board

Bryan L Martin, DO  Associate Dean for Graduate Medical Education, Designated Institutional Official, Associate Medical Director, Director, Allergy Immunology Program, Professor of Medicine and Pediatrics, Ohio State University College of Medicine

Bryan L Martin, DO is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology, American College of Osteopathic Internists, American College of Physicians, American Medical Association, and American Osteopathic Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Elliot Goldberg, MD  Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine

Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, and American College of Rheumatology

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Vecihi Batuman, MD, FACP, FASN  Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Medicine Service, Southeast Louisiana Veterans Health Care System

Vecihi Batuman, MD, FACP, FASN is a member of the following medical societies: American College of Physicians, American Society of Hypertension, American Society of Nephrology, and International Society of Nephrology

Disclosure: Nothing to disclose.

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Pulmonary alveolar capillaritis.
Histopathology of alveolar hemorrhage in alveolar capillaritis.
Crescentic glomerulonephritis.
Focal segmental glomerulonephritis.
Histopathology of leukocytoclastic angiitis.
Leukocytoclastic angiitis.
 
 
 
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