RENAL VASCULAR INVOLVEMENT IN A CASE OF POLYMYALGIA RHEUMATIC A WITH TEMPORAL ARTERITIS

Abstract. A case of polymyalgia rheumatica and temporal arteritis with renal arteriolar involvement is presented. Successive renal biopsies before, during and after steroid therapy showed an active inflammatory process in the renal arterioles visible as an intense PAS-positive staining of the intimal layer, reversible during steroid therapy and succeeded by increasing fibrotic thickening. Glomerular histological changes associated with the disease were not present. Renal function and urinary findings were normal. It is suggested that the vascular lesions encountered in this case indicate a disseminating arteritis as the underlying disease process. Although renal symptoms and signs in cases of temporal arteritis and polymyalgia rheumatica have been reported, no specific vascular lesions reversible by steroid therapy and verified by successive biopsies have, to the authors' knowledge, been described previously. Definite conclusions about the renal vascular lesions in polymyalgia rheumatica and temporal arteritis await final confirmation from larger series with renal biopsies.