Tongue and fingers gangrene – a rare manifestation of systemic ANCA-associated vasculitis


DOI: https://dx.doi.org/10.18565/therapy.2021.6.98-103

Skvortsov A.V., Bulanov N.M., Sorokin Yu.D., Saltykov B.B., Novikov P.I., Moiseev S.V.

I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University)
Abstract. Systemic vasculitis associated with antibodies to the cytoplasm of neutrophils (ANCA) is a group of autoimmune diseases characterized by inflammatory damage of small vessels of various organs. Despite frequent damage of skin and mucous membranes, the development of soft tissue gangrene for ANCA-associated vasculitis is not common. The article presents a clinical observation of female patient, whose clinical course of the generalized form of ANCA-associated vasculitis was complicated by tongue and fingers’ necrotic changes formation. Despite the intravital diagnosis and timely initiation of immunosuppressive therapy, the severe course of the disease led to the development of multiple organ failure and death. Diagnosis was confirmed by autopsy, during which tongue arterioles vasculitis signs were revealed, which made it possible to fix the genesis of necrotic changes and their direct connection with main disease.
Keywords: gangrene, antibodies to the cytoplasm of neutrophils, immunosuppressive therapy, glomerulonephritis
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About the Autors

Alexey V. Skvortsov, 6th year student of N.V. Sklifosovsky Institute of clinical medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 11/5 Rossolimo Str. Tel.: +7 (967) 197-65-62. E-mail: quasime14@gmail.com. ORCID: 0000-0001-8743-5207
Nikolay M. Bulanov, PhD, assistant of the Department of internal occupational diseases and rheumatology of N.V. Sklifosovsky Institute of clinical medicine, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 11/5 Rossolimo Str. Tel.: +7 (919) 100-22-79. E-mail: nmbulanov@gmail.com. ORCID: 0000-0002-3989-2590
Yuri D. Sorokin, head of the department of reanimation and intensive care No. 1 of the clinic of rheumatology, nephrology and occupational pathology named after E.M. Tareev of University clinical hospital No. 3, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 11 building 4, 5 Rossolimo Str. Tel.: +7 (916) 690-28-55. E-mail: sorokin-doc@mail.ru
Boris B. Saltykov, MD, professor of the Department of pathological anatomy named after academician A.I. Strukov, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University).Address: 119048, Moscow, 8 building 1 Trubetskaya Str. Tel.: +7 (985) 782-60-65. E-mail: prof.saltykov@mma.ru
Pavel I. Novikov, PhD, head of the rheumatology Department of the clinic of rheumatology, nephrology and occupational pathology named after E.M. Tareev of University clinical hospital No. 3, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 11 building 4, 5 Rossolimo Str. Tel.: +7 (985) 625-07-26. E-mail: novikov-pavel@mail.ru
Sergey V. Moiseev, MD, head of the Department of internal, occupational diseases and rheumatology, director of the clinic of rheumatology, nephrology and occupational pathology named after E.M. Tareev University Clinical Hospital No. 3, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of Russia (Sechenov University). Address: 119991, Moscow, 11 building 4, 5 Rossolimo Str. Tel.: +7 (916) 686-41-66. E-mail: avt420034@gmail.com. ORCID: 0000-0002-7232-4640


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