Vasculitis look-alikes: variants of renal atheroembolic disease.

the wife does not have any other option, since her husband previously been shown to have a subcritical stenosis. He was is the sole breadwinner of the family and she feels it is her established on regular dialysis therapy 14 months after the duty to save him. initial presentation. Our results are skewed, as out of a small number of 33 This man’s acute uraemic episode appeared clinically and patients, four were lost to follow-up and nine patients died histologically to be due to Henoch–Schonlein purpura. with normal functioning grafts. Of the remaining 20 patients, Immunosuppressive therapy appeared to result in sympto19 have normal renal functions. Although the graft survival matic improvement and partially improved renal function. of spouse transplants is comparable to that of all other living However, the close temporal association between the angidonors with the exception of HLA identical siblings [2], oplasty and the development of the skin rash and symptoms considering our social circumstances, it is our policy to might suggest that this is a further case of renal and cutaneous consider wife only if no other donor is available. necrotizing vasculitis arising as a complication of atheroembolic disease. The mechanism whereby cholesterol Departments of Nephrology and Dipankar Bhowmik 1Surgery Suresh C. Dash embolization might induce a systemic vasculitic response All India Institute of Medical Suresh C. Tiwari remain to be elucidated. However, necrotizing vasculitis Sciences Sanjay K. Agarwal should be added to the protean manifestations of the cholesNew Delhi Sanjay Gupta terol embolisation syndrome. India Sandeep Guleria1 Sadanand Mehta1 The General Infirmary at Leeds A. Kumar Great George Street J. H. Turney 1. Mathieson PW, Jolliffe D, Jolliffe R, Dudley CRK, Hamilton K, Lear PA. The spouse as a kidney donor: ethically sound? Nephrol Leeds Dial Transplant 1999; 14: 46–48 UK 2. Terasaki PI, Cecka M, Gjertson DW, Takemoto S. High survival rates of kidney transplants from spousal and living unrelated 1. Goldman M, Thona Y, Dhaene M, Toussaint C. Necrotising donors. N Engl J Med 1995; 333: 333–336 glomerulonephritis associated with cholesterol microemboli. Br Med J 1985; 290: 205–206 2. Ballesteros AL, Bromsoms J, Valles J, Llistosella E, Garijo G, Bernado L, Mauri JM. Vasculitis look-alikes: variants of renal atheroembolic disease. Nephrol Dial Transplant 1999; 14: 430–433 Vasculitis look-alikes: variants of renal atheroembolic disease