Complications

Complication
Timeframe
Likelihood
long term
high

A complication of long-term corticosteroid treatment. Prophylaxis with calcium supplementation and vitamin D is recommended unless contraindications exist. Early consideration to treatment with a bisphosphonate should be given. Scheduled bone density screening may be considered.

Osteoporosis

long term
medium

May complicate long-term corticosteroid use. Incidence in patients treated for MNM is not known. Increasing proximal weakness without new sensory loss may be consistent with corticosteroid myopathy.

variable
high

May arise as a result of long-term corticosteroid treatment. Monitoring of blood glucose should be performed during corticosteroid treatment. Treatment for diabetes mellitus should be started if needed.

variable
medium

This is a frequent feature of systemic vasculitis.[8] Granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis), microscopic polyarteritis, eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome), and lupus frequently involve the kidney, and rheumatoid vasculitis involves the kidney in about 10% to 25% of patients.[34]

variable
medium

Pulmonary disease is a frequent feature of granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis), microscopic polyarteritis, eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome), and sarcoidosis, and is less frequent in rheumatoid vasculitis.[34]

variable
medium

Gastrointestinal manifestations occur in about 50% of patients. The potentially catastrophic complications of polyarteritis nodosa include mesenteric infarction.[58]

variable
medium

Opportunistic infections (bacterial, fungal, and viral) may occur as a result of immunosuppression. Any evidence of infection while under immunosuppressive therapy should be treated aggressively.

variable
low

May be a feature of extrapulmonary sarcoidosis. The primary vasculitides that cause MNM have a risk of cardiac involvement of about 10% to 30%.[34] The potentially catastrophic complications of polyarteritis nodosa include arterial aneurysm rupture.[58]

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