Zandi Michael S, Coles Alasdair J
Department of Clinical Neurosciences, University of Cambridge, Box 165, Addenbrooke's Hospital, Cambridge, UK.
J Neurol Neurosurg Psychiatry. 2007 May;78(5):444-9. doi: 10.1136/jnnp.2006.091991.
To save their patients from dialysis and transplantation, neurologists need simply remain alert to the possibility of renal failure, particularly in the context of systemic disease, diabetes, sepsis and drugs. Of the numerous territories shared by our respective specialities, we outline a pragmatic approach to the diagnosis and treatment of the vasculitides, underpinned by knowing which questions to ask, equally importantly when to ask them, and in the art of obtaining a tissue diagnosis. We consider the current evolving trial evidence that directs the usage of a growing arsenal of therapies in the induction and maintenance stages of vasculitis treatment, and extend this consideration to Lupus and Sjogren's.
为了使患者免于透析和移植,神经科医生只需时刻警惕肾衰竭的可能性,尤其是在患有全身性疾病、糖尿病、败血症和药物相关疾病的情况下。在我们各自专业的众多交叉领域中,我们概述了一种针对血管炎诊断和治疗的实用方法,其基础是知道该问哪些问题,同样重要的是何时提问,以及获取组织诊断的技巧。我们考虑了当前不断发展的试验证据,这些证据指导了在血管炎治疗的诱导和维持阶段使用越来越多的治疗手段,并将这一考虑扩展到狼疮和干燥综合征。