Glomerular diseases are one of the most challenging entities in terms of diagnosis and management, especially when associated with systemic illnesses such as malignant disorders. Herein, a case of crescentic glomerulonephritis (CrGN) associated with polycythaemia vera (PV) in a 50-year-old female is described. She presented with bilateral pedal oedema, splenomegaly, renal dysfunction and severe proteinuria. On evaluation, we found PV and CrGN. The possible pathogenesis of PV associated-renal disease may be as follows:
-An increase in blood volume and viscosity causes passive expansion of the capillaries and intimal injury, ultimately leading to tissue ischaemia and renal injury
-PV is often associated with hypertension and hyperuricemia, which affect renal microcirculation
-The medications used for PV treatment can cause renal impairment e.g., interferon, hydroxyurea
-Abnormal activation of megakaryocytes leading to glomerulosclerosis
-Various cytokines and growth factors PDGF, TGF- has also been implicated in the pathogenesis.
Renal involvement in PV is rare and generally considered as a manifestation of hypervolemia or high-viscosity-induced renal hyper-perfusion and hyper-filtration. This is a unique case of immunologically-mediated renal disease in PV.
Source: https://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2022;volume=32;issue=2;spage=156;epage=159;aulast=Dwivedi
-An increase in blood volume and viscosity causes passive expansion of the capillaries and intimal injury, ultimately leading to tissue ischaemia and renal injury
-PV is often associated with hypertension and hyperuricemia, which affect renal microcirculation
-The medications used for PV treatment can cause renal impairment e.g., interferon, hydroxyurea
-Abnormal activation of megakaryocytes leading to glomerulosclerosis
-Various cytokines and growth factors PDGF, TGF- has also been implicated in the pathogenesis.
Renal involvement in PV is rare and generally considered as a manifestation of hypervolemia or high-viscosity-induced renal hyper-perfusion and hyper-filtration. This is a unique case of immunologically-mediated renal disease in PV.
Source: https://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2022;volume=32;issue=2;spage=156;epage=159;aulast=Dwivedi
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