How is granulomatosis with polyangiitis associated with end-stage renal disease (ESRD)?

Updated: Mar 05, 2020
  • Author: Julia R Nunley, MD; Chief Editor: Dirk M Elston, MD  more...
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Granulomatosis with polyangiitis is an uncommon systemic disorder characterized by granulomatous and necrotizing inflammation of the upper and lower respiratory tracts and the kidneys. Chronic renal failure occurs in 35% of patients. Skin involvement occurs in 14-77% of patients and is associated with a higher frequency of renal involvement. [9, 10] Cutaneous lesions include purpura (most commonly on lower legs), subcutaneous nodules, and ulcers.

Although cutaneous biopsy findings are frequently nonspecific, 2 distinct histologic findings have been described, including leukocytoclastic vasculitis and granulomatous inflammation. Leukocytoclastic vasculitis is more common and is associated with palpable purpura, a more aggressive course, a higher frequency of renal disease, and an overall poorer prognosis.

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