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Systemic Vasculitis and the Kidney 271

Conclusion

Upon hearing the first case reports of patients with GPA [34], Ludwig Aschoff, a
renowned German pathologist, described the disease as “a new and very special disease.” [83]
Over the past three decades, tremendous progress, more than could have been imagined as
recently as the late 20th century, has been made through investigative efforts to understand the
etiologies, pathogenesis and clinical management of AAV and glomerulonephritis. They have
been transformed from diseases that were usually fatal to diseases that are chronic and
manageable, with the potential for long-term, symptom-free remission. Nevertheless, many
challenges remain. Ideally, investigations will focus on increasing the understanding of
molecular mechanisms of genetic and environmental risk factors for disease, decreasing
diagnostic delays so as to lessen the impact of disease on patients? health, and further defining
and personalizing treatment strategies that will induce and maintain remission while
minimizing occurrence of relapse. Future pursuits, built upon the foundation of discoveries to
date, may well lead to a cure.

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