<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2184-0628</journal-id>
<journal-title><![CDATA[Gazeta Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Gaz Med]]></abbrev-journal-title>
<issn>2184-0628</issn>
<publisher>
<publisher-name><![CDATA[Círculo Médico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2184-06282022000400357</article-id>
<article-id pub-id-type="doi">10.29315/gm.v1i1.537</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Vasculite IgA e glomerulonefrite C3: Um Doente&#8230;Várias Doenças Autoimunes]]></article-title>
<article-title xml:lang="en"><![CDATA[IgA Vasculitis and C3 Glomerulonephritis: One Patient... Various Autoimmune Diseases]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gaudêncio]]></surname>
<given-names><![CDATA[Margarida]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lameiras]]></surname>
<given-names><![CDATA[Ana Catarina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mendonça]]></surname>
<given-names><![CDATA[Teresa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Distrital da Figueira da Foz, EPE Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Figueira da Foz ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Fernando Fonseca Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Amadora ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Hospitalar e Universitário do Porto Unidade de Imunologia Clínica ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto de Ciências Biomédicas Abel Salazar Faculdade de Medicina ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<volume>9</volume>
<numero>4</numero>
<fpage>357</fpage>
<lpage>360</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2184-06282022000400357&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2184-06282022000400357&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2184-06282022000400357&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Leucocytoclastic vasculitis refers to a small vessel vasculitis caused by immune complexes, infections and medications. IgA or IgM/IgG immune complexes can be found in direct immunofluorescence studies suggesting specific forms of leucocytoclastic vasculitis. Some authors suggested that IgA vasculitis and IgA nephropathy were two clinical manifestations of the same disease. From a histological point of view, it is not possible to distinguish a glomerulonephritis as part of an IgA vasculitis from an IgA nephropathy. The authors present a case of a 50-year-old woman diagnosed with vitiligo ad immune thrombocytopenic purpura (ITP). ITP was diagnosed 2 years before the present case. She presented to the autoimmune diseases&#8217; appointment with a pruriginous rash of the lower extremities over the last 3 months. Skin biopsy was suggestive of leukocytoclastic vasculitis, revealing deposits of C3, IgG (less intensity) and IgA. IgA vasculitis was then assumed. After a few weeks, she kept peripheral edema, but an increasing decline in renal function was detected. Therefore, a renal biopsy was performed, which revealed endocapilar proliferative glomerulonephritis and predominantly C3 mesangial deposits, with IgA and vestigial IgM. These results were compatible with a C3 glomerulonephritis. The patient was started on systemic steroid treatment with prednisolone 1 mg/kg/day and ramipril 2.5 mg/day with progressive normalization of renal function. With this case, the authors emphasize the possibility that all these manifestations could be part of the same disease spectrum, but also, the importance of complement activation. So, this case may constitute additional evidence of the complement activation in pathogenesis of this vasculitis, however, further investigation is need, particularly to understand C3 glomerulonephritis, a rare kidney disease.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo A vasculite leucocitoclástica caracteriza-se por atingir pequenos vasos e ser provocada por complexos imunes, infeções e fármacos. Complexos imunes IgA ou IgM/IgG podem ser encontrados em imunofluorescência direta, sugerindo formas específicas desta vasculite. Alguns autores sugerem que a vasculite IgA e a nefropatia IgA são duas manifestações clínicas da mesma doença. Do ponto de vista histológico, não é possível distinguir ambas as entidades. Os autores apresentam o caso de uma mulher, 50 anos, com diagnóstico de vitiligo e púrpura trombocitopénica idiopática. Este diagnóstico foi realizado dois anos antes do presente caso. A doente apresentou-se na consulta de doenças autoimunes com história de exantema pruriginoso dos membros inferiores e edema com 3 meses de evolução. A biópsia cutânea foi sugestiva de vasculite leucocitoclástica, com depósitos de C3, IgG (menor quantidade) e IgA. Foi assumido o diagnóstico de vasculite IgA. Após algumas semanas, a doente mantinha edema periférico, mas com agravamento da função renal. Pelo que, foi realizada uma biópsia renal, que revelou a presença de glomerulonefrite proliferativa endocapilar, com predomínio de depósitos C3 mesangiais, mas igualmente, depósitos IgA e IgM vestigial. Estes resultados são compatíveis com uma glomerulonefrite C3. A doente iniciou corticoterapia sistémica com prednisolona 1 mg/kg/dia e ramipril 2,5 mg/dia, com normalização da função renal. Com este caso, os autores enfatizam a possibilidade de todas estas manifestações poderem fazer parte do mesmo espectro de doença, bem como, a importância da ativação do complemento na fisiopatologia da doença. Este caso constitui uma evidência adicional da importância da ativação do complemento na patogénese da vasculite IgA. No entanto, é necessária maior evidência e investigação, particularmente para compreender a glomerulonefrite C3, uma doença renal rara.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Complemento C3]]></kwd>
<kwd lng="pt"><![CDATA[Doenças do Rim]]></kwd>
<kwd lng="pt"><![CDATA[Glomerulonefrite IgA]]></kwd>
<kwd lng="pt"><![CDATA[Vasculite IgA]]></kwd>
<kwd lng="en"><![CDATA[Complement C3]]></kwd>
<kwd lng="en"><![CDATA[Glomerulonephritis, IgA]]></kwd>
<kwd lng="en"><![CDATA[IgA Vasculitis]]></kwd>
<kwd lng="en"><![CDATA[Kidney Diseases]]></kwd>
<kwd lng="en"><![CDATA[Kidney Glomerulus]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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