И.А.Козыро, А.В. Сукало
Белорусский государственный медицинский университет
В статье приведены современные данные литературы по проблеме системных васкулитов (СВ) с поражением почек у детей. СВ нечасто встречаются в детском возрасте, однако характеризуются тяжелым прогрессирующим течением, в конечном итоге приводящим к ранней инвалидизации пациентов. Это группа заболеваний с широким спектром клинических проявлений, важнейшим патоморфологическим признаком которых является воспаление стенки кровеносных сосудов с развитием тромбозов, некрозов, склеротических изменений.
ключевые слова: системный васкулит, гломерулонефрит, дети

для цитирования: И.А.Козыро, А.В. Сукало. Современные возможности диагностики и лечения системных васкулитов с поражением почек у детей: обзор литературы (Часть 1). Неотложная кардиология и кардиоваскулярные риски, 2020, Т. 4, № 1, С. 917–924

Modern opportunities for diagnosis and treatment of systemic vasculitis with kidney involvement in children: review of literature (part 1)
I.A. Kazyra, A.V. Sukalo
The article presents current literature data on the problem of systemic vasculitis (SV) with kidney involvement in children. SV is rare in childhood, but is characterized by a severe progressive course, ultimately leading to early disability. This is a group of diseases with a wide range of clinical manifestations, the most important pathomorphological sign of which is inflammation of the blood vessel wall with the development of thrombosis, necrosis, and sclerotic lesions.
keywords: systemic vasculitis, glomerulonephritis, children

for references: I.A. Kazyra, A.V. Sukalo. Modern opportunities for diagnosis and treatment of systemic vasculitis with kidney involvement in children: review of literature (part 1). Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2020, vol. 4, no. 1, pp. 917–924

1. Savenkova N.D. Strategiya terapii ANCA-assoziirovannogo vaskulita u detey i podrostkov [Treatment strategy ANCA-associated renal vasculitides in children and adolescents]. Nefrologiya, 2019, vol. 23, no. 5, pp. 106-115. doi: 10.24884/1561-6274-2019-23-5-107-115. (in Russian)
2. Sunderkötter C.H., Zelger B., Chen K.R., Requena L., Piette W., Carlson J.A., Dutz J., Lamprecht P., Mahr A., Aberer E., Werth V.P., Wetter D.A., Kawana S., Luqmani R., Frances C., Jorizzo J., Watts J.R., Metze D., Caproni M., Alpsoy E., Callen J.P., Fiorentino D., Merkel P.A., Falk R.J., Jennette J.C. Nomenclature of Cutaneous Vasculitis: Dermatologic Addendum to the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheumatol, 2018, vol. 70, no. 2, pp. 171-184. doi: 10.1002/art.40375.
3. Jennette J.C., Nachman P.H. ANCA Glomerulonephritis and Vasculitis. Clin J Am Soc Nephrol, 2017, vol. 12, no. 10, pp. 1680-1691. doi:10.2215/CJN.02500317.
4. Sinico R.A., Di Toma L., Radice A. Renal involvement in anti-neutrophil cytoplasmic autoantibody associated vasculitis. Autoimmun Rev, 2013, vol. 12, no. 4, pp. 477-482. doi: 10.1016/j.autrev.2012.08.006.
5. Arulkumaran N., Jawad S., Smith S.W., Harper L., Brogan P., Pusey C.D., Salama A.D. Long- term outcome of paediatric patients with ANCA vasculitis. Pediatr Rheumatol Online J, 2011, vol. 19, no. 9, pp. 12. doi: 10.1186/1546-0096-9-12.
6. Plumb L.A., Oni L., Marks S.D., Tullus K. Paediatric anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis: an update on renal management. Pediatr Nephrol, 2018, vol. 33, no. 1, pp. 25-39. doi: 10.1007/s00467-016-3559-2.
7. Berden A.E., Ferrario F., Hagen E.C., Jayne D.R., Jennette J.C., Joh K., Neumann I., Noël L.H., Pusey C.D., Waldherr R., Bruijn J.A., Bajema I.M. Histopathologic classification of ANCA-associated glomerulonephritis. J Am Soc Nephrol, 2010, vol. 21, no. 10, pp. 1628-36. doi: 10.1681/ASN.2010050477.
8. Siomou E., Tramma D., Bowen C., Milford D.V. ANCA-associated glomerulonephritis/systemic vasculitis in childhood: clinical features-outcome. Pediatr Nephrol, 2012, vol. 27, no. 10, pp. 1911-1920. doi: 10.1007/s00467-012-2198-5.
9. Grisaru S., Yuen G.W., Miettunen P.M., Hamiwka L.A. Incidence of Wegener’s granulomatosis in children. J Rheumatol, 2010, vol. 37, no 2, pp. 440-402. doi: 10.3899/jrheum.090688.
10. Hirano D., Ishikawa T., Inaba A., Sato M., Shinozaki T., Iijima K., Ito S. Epidemiology and clinical features of childhood-onset anti-neutrophil cytoplasmic antibodyassociated vasculitis: a clinicopathological analysis. Pediatr Nephrol, 2019, vol. 34, no. 8, pp. 1425-1433. doi: 10.1007/s00467-019-04228-4.
11. Jariwala M.P., Laxer R.M. Primary Vasculitis in Childhood: GPA and MPA in Childhood. Front Pediatr, 2018, vol. 16, no. 6, pp. 226. doi: 10.3389/fped.2018.00226. eCollection 2018. Review.
12. Calatroni M., Oliva E., Gianfreda D., Gregorini G., Allinovi M., Ramirez G.A., Bozzolo E.P., Monti S., Bracaglia C., Marucci G., Bodria M., Sinico R.A., Pieruzzi F., Moroni G., Pastore S., Emmi G., Esposito P., Catanoso M., Barbano G., Bonanni A., Vaglio A. ANCA-associated vasculitis in childhood: recent advances. Ital J Pediatr, 2017, vol. 43, no. 1, pp. 46. doi: 10.1186/s13052-017-0364-x.
13. Xiao H., Hu P., Falk R.J., Jennette J.C. Overview of the Pathogenesis of ANCA-Associated Vasculitis. Kidney Dis (Basel), 2016, vol. 1, no. 4, pp. 205-215. doi: 10.1159/000442323.
14. Scott D.G., Watts R.A. Epidemiology and clinical features of systemic vasculitis. Clin Exp Nephrol, 2013, vol. 17, no. 5, pp. 607-610. doi: 10.1007/s10157-013-0830-8.
15. Lyons P.A., Rayner T.F., Trivedi S., Holle J.U., Watts R.A., Jayne D.R., Baslund B., Brenchley P., Bruchfeld A., Chaudhry A.N., Cohen Tervaert J.W., Deloukas P., Feighery C., Gross W.L., Guillevin L., Gunnarsson I. et al. Genetically distinct subsets within ANCA-associated vasculitis. N Engl J Med, 2012, vol. 367, no. 3, pp. 214-223. doi: 10.1056/NEJMoa1108735.
16. Kouri A.M., Andreoli S.P. Clinical presentation and outcome of pediatric ANCA-associated glomerulonephritis. Pediatr Nephrol, 2017, vol. 32, no. 3, pp. 449-455. doi: 10.1007/s00467-016-3490-6.
17. Chipczyńska B., Grałek M., Hautz W., Zegadło-Mylik M., Kocyła-Karczmarewicz B., Kanigowska K., Seroczyńska M., Kepa B., Klimczak-Slaczka D. Orbital tumor as an initial manifestation of Wegener’s granulomatosis in children: a series of four cases. Med Sci Monit, 2009, vol. 15, no. 8, pp. CS135-138.
18. Pagnoux C. Carette S., Khalidi N.A., Walsh M., Hiemstra T.F., Cuthbertson D., Langford C., Hoffman G., Koening C.L., Monach P.A., Moreland L., Mouthon L., Seo P., Specks U., Ytterberg S., Westman K., Hoglund P., Harper L., Flossman O., Luqmani R., Savage C.O. et al. Comparability of patients with ANCA-associated vasculitis enrolled in clinical trials or in observational cohorts. Clin Exp Rheumatol, 2015, vol. 33, no. 2(Suppl 89), pp. S77-83.
19. Sanders J.S., Stassen P.M., van Rossum A.P., Kallenberg C.G., Stegeman C.A. Risk factors for relapse in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis: tools for treatment decisions? Clin Exp Rheumatol, 2004, vol. 22, no. 6(Suppl 36), pp. S94-101.
20. Wulffraat N.M., Vastert B. Time to share. Pediatr Rheumatol Online J, 2013, vol. 15, no. 11(1), pp. 5. doi: 10.1186/1546-0096-11-5.
21. de Graeff N., Groot N., Brogan P., Ozen S., Avcin T., Bader-Meunier B., Dolezalova P., Feldman B.M., Kone-Paut I., Lahdenne P., Marks S.D., McCann L., Pilkington C. et al. European consensus-based recommendations for the diagnosis and treatment of rare paediatric vasculitides – the SHARE initiative. Rheumatology (Oxford), 2019, vol. 58, no. 4, pp. 656-671. doi: 10.1093/rheumatology/key322.
22. Dolezalova P., Price-Kuehne F.E., Özen S., Benseler S.M., Cabral D.A., Anton J., Brunner J., Cimaz R., O’Neil K.M., Wallace C.A., Wilkinson N., Eleftheriou D., Demirkaya E., Böhm M., Krol P., Luqmani R.A., Brogan P.A. Disease activity assessment in childhood vasculitis: development and preliminary validation of the Paediatric Vasculitis Activity Score (PVAS). Ann Rheum Dis, 2013, vol. 72, no. 10, pp. 1628-1633. doi: 10.1136/annrheumdis-2012-202111.
23. Hiemstra T.F., Walsh M., Mahr A., Savage C.O., de Groot K., Harper L., Hauser T., Neumann I., Tesar V., Wissing K.M., Pagnoux C., Schmitt W., Jayne D.R. Mycophenolate mofetil vs azathioprine for remission maintenance in antineutrophil cytoplasmic antibody-associated vasculitis: a randomized controlled trial. JAMA, 2010, vol. 304, no. 21, pp. 2381-2388. doi: 10.1001/jama.2010.1658.
24. Walsh M., Merkel P.A., Peh C.A., Szpirt W., Guillevin L., Pusey C.D., De Zoysa J., Ives N., Clark W.F., Quillen K., Winters J.L., Wheatley K., Jayne D. Plasma exchange and glucocorticoid dosing in the treatment of anti-neutrophil cytoplasm antibody associated vasculitis (PEXIVAS): protocol for a randomized controlled trial. Trials, 2013, vol. 14, no. 14, pp. 73. doi: 10.1186/1745-6215-14-73.
25. Jones R.B., Furuta S., Tervaert J.W., Hauser T., Luqmani R., Morgan M.D., Peh C.A., Savage C.O., Segelmark M., Tesar V., van Paassen P., Walsh M., Westman K., Jayne D.R. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis: 2-year results of a randomised trial. Ann Rheum Dis, 2015, vol 74, no. 6, pp. 1178-1182. doi: 10.1136/annrheumdis-2014-206404.
26. Harper L., Harper L1, Morgan MD, Walsh M, Hoglund P, Westman K, Flossmann O, Tesar V, Vanhille P, de Groot K, Luqmani R, Flores-Suarez LF, Watts R, Pusey C, Bruchfeld A, Rasmussen N, Blockmans D, Savage CO, Jayne D EUVAS investigators. Pulse versus daily oral cyclophosphamide for induction of remission in ANCA-associated vasculitis: long-term follow-up. Ann Rheum Dis, 2012, vol. 71, no. 6, pp. 955-960. doi: 10.1136/annrheumdis-2011-200477.
27. Laurino S., Chaudhry A., Booth A., Conte G., Jayne D. Prospective study of TNFalpha blockade with adalimumab in ANCA-associated systemic vasculitis with renal involvement. Nephrol Dial Transplant, 2010, vol. 25, no. 10, pp. 3307-3314. doi: 10.1093/ndt/gfq187.
28. Jones R.B., Hiemstra T.F., Ballarin J., Blockmans D.E., Brogan P., Bruchfeld A., Cid M.C., Dahlsveen K., de Zoysa J., Espigol-Frigolé G., Lanyon P., Peh C.A., Tesar V., Vaglio A., Walsh M., Walsh D., Walters G., Harper L., Jayne D. Mycophenolate mofetil versus cyclophosphamide for remission induction in ANCA-associated vasculitis: a randomised, non-inferiority trial. Ann Rheum Dis, 2019, vol. 78, no. 3, pp. 399-405. doi: 10.1136/annrheumdis-2018-214245.
29. Faurschou M., Jayne D.R. Anti-B cell antibody therapies for inflammatory rheumatic diseases. Annu Rev Med. 2014, vol. 65, pp. 263-278. doi: 10.1146/annurevmed-070912-133235. Epub 2013 Oct 18
30. Geetha D., Eirin A., True K., Valentina Irazabal M., Specks U., Seo P., Nachman P., Fervenza F.C. Renal transplantation in antineutrophil cytoplasmic antibody-associated vasculitis: a multicentre experience. Transplantation, 2011, vol. 91, no. 12. pp. 1370-1375. doi: 10.1097/TP.0b013e31821ab9aa.
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