Necrotizing vasculitis and Wegener's granulomatosis

December 29th, 2012

 necrotizing vasculitis, Wegener's granulomatosis
 This type of vasculitis is also called non-infectious necrotizing granulomatosis necrotizing granulomatosis or upper respiratory tract. For the first time the disease was described in 1931 as a special type of periarteritis nodosa, in 1936 after a more detailed description of F. Wegener it was named.

 Necrotizing vasculitis and Wegener's granulomatosis

Why and how necrotizing vasculitis begins

Wegener's granulomatosis - a systemic vasculitis Vasculitis - when blood vessels refuse to work  Vasculitis - when blood vessels refuse to work
   with the development of necrotizing granulomas in the tissues. This form of vasculitis affects small vessels of the upper airways, lungs and kidneys.

The main cause of the disease - an autoimmune process that is allergic to the patient's own tissue, which apparently started after a viral or bacterial infection. In this case, the body produces antibodies against one type of leukocyte - neutrophils, due to which is now called Wegener granulomatosis disease associated with anti-neutrophil cytoplasmic antibody (ANCA). In the walls of arteries developing inflammation with formation of granulomas.

A granuloma is a cluster of cells capable of phagocytosis (dissolution inside pathogens). Externally granuloma nodules appear as different sizes, inside which there is necrosis, after which they are replaced with connective tissue (creating sclerosis), with a gradual decline of organ function.

 Necrotizing vasculitis and Wegener's granulomatosis

The disease

The disease usually has a subacute or chronic course. In its course, there are three periods:

  • initial manifestations of the changes of the upper respiratory tract, the middle ear or eye;
  • period generalization visceral (mainly lung and kidney);
  • terminal period - with impaired kidney and lungs.

 Necrotizing vasculitis and Wegener's granulomatosis

Initial symptoms

Disease begins gradually with repeated rhinitis, sinusitis or sinusitis. Sometimes the first symptoms of lung disease and if the patient has a strong cough, fever, and sometimes - the blood in the sputum. Purulent inflammation of the middle ear can also be the beginning of vasculitis. Less commonly, the disease begins with damage to eyes, skin and joints. Usually, at the very beginning of the disease the patient has malaise, fever, lack of appetite and weight loss.

 Necrotizing vasculitis and Wegener's granulomatosis

The main symptoms of the disease

For necrotizing vasculitis characterized by the classic triad - the defeat of the upper respiratory tract, lung and kidney, along with general signs of disease and less frequent symptoms.

Common signs include fever, which appears both in local and in generalized lesions. More than half of patients have joint damage in the form of joint pain, which usually appear at the peak of disease recurrence. Pains arise in large and small joints. Sometimes it can develop inflammation (arthritis) in large joints. Arthritis often develop in the knee and ankle joints (from two sides).

Changes in the skin and muscles are also developing quite often. A rash on the skin can be varied: hemorrhagic (bleeding a), papular (small hill above the skin), bullous (blisters). The most typical of hemorrhagic rashes, ulcers and necrotic nodules. The degree of skin lesions may be different - from single components to the destruction of vast areas. Elements of the rash often located in large joints, on the buttocks and thighs.

 Necrotizing vasculitis and Wegener's granulomatosis

The defeat of the respiratory system

Symptoms of upper respiratory tract are observed in all patients. The disease begins with rhinitis Rhinitis: a runny nose - is quite serious  Rhinitis: a runny nose - is quite serious
   and sinusitis Sinusitis - when a puncture is required  Sinusitis - when a puncture is required
 . There are pus mixed with blood from the nose, stuffy nose, dry crusts, epistaxis, olfactory disorders, headaches, swelling in the back of the nose, or one half of the face.

Long-term course of the disease leads to the characteristic lesions of the mucous membranes of the pharynx, larynx, trachea, accompanied by a sore throat, hoarseness, and respiratory disorders. Perhaps the destruction of cartilage and bone of the nasal septum, maxillary sinus and the organ of vision.

Sometimes the symptoms of angina Symptoms of angina - obvious and recognizable  Symptoms of angina - obvious and recognizable
 . Purulent processes develop when joining a bacterial infection.

If it affects the lungs appears hacking cough, chest pain, coughing up blood, shortness of breath. The lungs are formed rounded infiltrates, necrosis and decay cavities which are formed, which are then creating sclerosis with formation of pulmonary disease.

 Necrotizing vasculitis and Wegener's granulomatosis

The defeat of hearing and vision

Otitis media can be the first sign of the disease, sometimes complicated by paresis of the facial nerve. Perhaps granulomatous destruction of the temporal bone with the development of hearing loss.

The eyes are affected in about half of patients. Granulomatosis orbit of the eye can manifest as swelling in the form of a protrusion of the eyeball (exophthalmos), limiting its mobility, swelling of the eye tissues, including swelling of the optic nerve, which can lead to blindness.

 Necrotizing vasculitis and Wegener's granulomatosis


Signs of kidney damage usually appear within a few months after the onset of the disease. In the urine there is a large amount of protein and blood, kidney function has been steadily declining. About a year later the patient may appear high blood pressure. Chronic renal failure is formed in two or three years.

Necrotizing vasculitis - is a serious chronic disease. However, current treatments allow the process to stop when the disease was detected in a timely manner.

Galina Romanenko

Article Tags:
  • vasculitis

Nise - instruction: remember the side effects

October 21, 2011

 Nise - guide
 Nayz - drug, which relates to a group of non-steroidal antiinflammatory drugs. Patients with chronic diseases of joints and spine, which must constantly shoot inflammation and pain, are familiar with this drug.

 Nise - instruction: remember the side effects

The mechanism of action Naiza

Nise (nimesulide INN) - issued an Indian pharmaceutical company "Dr. Reddy's Laboratories Ltd." tablets. Naiza action mechanism is that it suppresses the activity of the enzyme cyclooxygenase-2 (COX-2). This enzyme is a member of the biochemical process of formation of prostaglandins - biologically active substances, the effect of which is the basis of the formation of inflammation, swelling and pain. As a result of the suppression of COX-2 reduces the formation of prostaglandins, removed heat, inflammation, swelling and pain.

The slightly inhibits the action of the enzyme cyclooxygenase-1 (COX-1), which protects the gastric mucosa from external influences. Therefore, chronic administration in large doses may experience signs of stomach irritation.

Nise also suppresses:

  • aggregation (adhesion) of platelets thereby preventing blood clots;
  • the release of histamine - the main substance (neurotransmitter) allergic reactions, so reduces the degree of bronchospasm in bronchial asthma, as well as other manifestations of allergic reactions;
  • release of tumor necrosis factor alpha, thereby preventing the destruction of the cartilage;
  • The myeloperoxidase enzyme activity, which are formed under the action of toxic breakdown products of oxygen (antioxidant action).

If ingestion is rapidly absorbed Nise and enters the bloodstream. Food intake can slow the absorption, but it is still completely suck. After absorption into the blood flows to the tissues Nise well penetrating the acidic environment of the source of inflammation. After expansion in the liver to metabolites (metabolites) excreted in urine and feces.

 Nise - instruction: remember the side effects

Indications and contraindications for receiving Naiza

Nise appoint the following diseases and conditions:

  • inflammatory joint diseases of different origin (arthritis, rheumatoid arthritis) - reduces inflammation and pain in the joints Joint pain - how to understand what is going on?  Joint pain - how to understand what is going on?
  • degenerative (metabolic) changes in the joints and spine (osteoarthritis, osteochondrosis) - reduced pain;
  • pain in the joints and muscles of different origin, including after injuries and operations - to reduce pain;
  • painful menstruation, headache, toothache - as an anesthetic;
  • high temperature of various origins - as an antipyretic agent.

Admission Naiza contraindicated:

  • in case of hypersensitivity to the drug;
  • in diseases of the gastrointestinal tract, accompanied by lesions of the mucous membrane of the stomach and intestines (chronic gastritis, gastric ulcer and duodenal ulcer, ulcerative colitis)
  • for violations of liver and kidney function;
  • intolerance to nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin-induced asthma when (when bronchospasm appear when taking any NSAID)
  • Pregnancy and breast- Breastfeeding - a personal choice  Breastfeeding - a personal choice
  • in children (up to twelve years).

The caution is recommended to take Nise high blood pressure, severe diseases of the cardiovascular system and diabetes Diabetes - threatening and incurable disease  Diabetes - threatening and incurable disease
   the second type.

 Nise - instruction: remember the side effects

Side effects that may occur while taking Naiza, and overdose

When receiving Naiza may experience the following side effects:

  • from the gastrointestinal tract - heartburn, nausea, vomiting, diarrhea, pain in the upper abdomen, ulceration of the mucosa of the gastrointestinal tract;
  • from the liver - a transient dysfunction;
  • the central nervous system - headache, dizziness;
  • Allergic reaction - skin rash, anaphylactic shock;
  • from blood: reducing the number of platelets (bleeding), leukocytes, including granular (immunosuppression), red blood cells (anemia), prolonged bleeding;
  • by the kidneys and urinary tract infections - blood in urine Blood in the urine - a reason for serious concern  Blood in the urine - a reason for serious concern
  • by the bronchopulmonary system - may cause bronchospasm.

Overdose of the drug will increase Naiza all the side effects, so you should immediately wash out the stomach. With prolonged use Naiza require laboratory monitoring of the liver and kidneys.

Care should be taken while the application Naiza with certain other drugs (other NSAIDs, diuretic, lowering blood pressure, anti-diabetic drugs, digoxin, phenytoin, drugs, lithium, cyclosporin, methotrexate).

Nise - a reliable, time-tested drug.

Galina Romanenko

Article Tags:
  • Nise