ANCA相關(guān)性血管炎腎損害病理表現(xiàn)課件

1、ANCA相關(guān)性血管炎腎損害病理表現(xiàn)1精選課件ANCA相關(guān)性血管炎腎損害病理表現(xiàn)1精選課件P-ANCA Perinuclear PatternAnti-myeloperoxidaseMPO-ANCAC-ANCA Cytoplasmic PatternAnti-Proteinase 3PR3-ANCAAnti-Neutrophil Cytoplasmic Autoantibodies (ANCA)2精選課件P-ANCA Perinuclear PatternC-AN Large Vessel VasculitisGiant Cell ArteritisTakayasu ArteritisMediu

2、m Vessel VasculitisPolyarteritis NodosaKawasaki DiseaseSmall Vessel VasculitisANCA-Associated Vasculitis（AASV）Microscopic PolyangiitisGranulomatosis with Polyangiitis (Wegeners)Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss)Immune Complex VasculitisAnti-GBM DiseaseIgA Vasculitis (Henoc

3、h-Schnlein)Cryoglobulinemic VasculitisHypocomplementemic Urticarial Vasculitis (Anti-C1q Vasculitis)Variable Vessel Vasculitis (Cogans, Behcets, etc.)Single Organ Vasculitis (cutaneous SVV, primary CNS vasculitis, etc.)Vasculitis Associated with Systemic Diseases (e.g. Rheumatoid, Lupus, Sarcoid, et

4、c.)Vasculitis Associated with Probable Etiologies (e.g. HBV, HCV, drug, cancer, etc.) 2011 Chapel Hill Consensus Conference Vasculitis Nomenclature3精選課件 Large Vessel Vasculitis2011 C光鏡腎小球節(jié)段性毛細(xì)血管袢纖維素樣壞死新月體性腎炎，多新舊不等腎小動(dòng)脈10%-50%可有腎小球外小動(dòng)脈纖維素樣壞死，部分可有中等動(dòng)脈受累腎間質(zhì)-小管炎癥，偶見(jiàn)肉芽腫樣病變偶見(jiàn)髓質(zhì)小管周圍炎免疫病理和電鏡微量或陰性ANCA相關(guān)小血管炎腎損

5、害病理表現(xiàn)4精選課件光鏡ANCA相關(guān)小血管炎腎損害病理表現(xiàn)4精選課件毛細(xì)血管袢纖維素樣壞死5精選課件毛細(xì)血管袢纖維素樣壞死5精選課件新月體形成細(xì)胞性新月體纖維細(xì)胞性新月體6精選課件新月體形成細(xì)胞性新月體纖維細(xì)胞性新月體6精選課件小動(dòng)脈纖維素樣壞死小葉間動(dòng)脈纖維素樣壞死腎間質(zhì)大量炎癥細(xì)胞浸潤(rùn)7精選課件小動(dòng)脈纖維素樣壞死小葉間動(dòng)脈纖維素樣壞死7精選課件小動(dòng)脈纖維素樣壞死小葉間動(dòng)脈纖維素樣壞死，內(nèi)膜水腫伴炎癥細(xì)胞浸潤(rùn)腎間質(zhì)大量炎癥細(xì)胞浸潤(rùn)8精選課件小動(dòng)脈纖維素樣壞死小葉間動(dòng)脈纖維素樣壞死，內(nèi)膜水腫伴炎癥細(xì)胞小動(dòng)脈纖維素樣壞死慢性化表現(xiàn)：小葉間動(dòng)脈管腔內(nèi)水腫，炎癥細(xì)胞浸潤(rùn) 血管腔內(nèi)膜和肌層均纖維化9精

6、選課件小動(dòng)脈纖維素樣壞死慢性化表現(xiàn)：小葉間動(dòng)脈管腔內(nèi)水腫，炎癥細(xì)胞小管間質(zhì)病變-炎細(xì)胞浸潤(rùn)10精選課件小管間質(zhì)病變-炎細(xì)胞浸潤(rùn)10精選課件小管間質(zhì)病變-炎細(xì)胞浸潤(rùn)11精選課件小管間質(zhì)病變-炎細(xì)胞浸潤(rùn)11精選課件小管間質(zhì)病變-炎細(xì)胞浸潤(rùn)12精選課件小管間質(zhì)病變-炎細(xì)胞浸潤(rùn)12精選課件小管間質(zhì)病變-壞死性肉芽腫形成13精選課件小管間質(zhì)病變-壞死性肉芽腫形成13精選課件免疫熒光-寡免疫性IgG40014精選課件免疫熒光-寡免疫性IgG40014精選課件免疫熒光左：纖維素樣壞死右：從一個(gè)纖維素樣壞死病灶蔓延至相鄰小新月體Fibrin40015精選課件免疫熒光左：纖維素樣壞死Fibrin40015精選課件電鏡毛細(xì)血管袢基底膜