Abstract |
We present a the case of 58-year old man who was admitted to hospital with typical clinical features (bloody nasal discharge, arthralgia, acute kidney injury with a nephritic syndrome) consisting with Wegeners granulomatosis (WG). CT-scan showed pulmonary nodules and antineutrophil cytoplasmatic antibodies ( ANCA) were elevated. A kidney biopsy showed a crescentic glomerulonephritis, but not pauci-immune-immune with a histopathological staining of a mesangioproliferative IgA-glomerulonephritis. The patient was put on prednisolone and i.v. cyclophosphamid ( CYCLOPS-protocol (1). The anti- proteinase-3 antibody titer decreased and the CT-scan showed decreased activity of Wegener's granulomatosis (BVAS 26 dropped to 2) and the patient`s serum creatinine level was stable. The exact nosological relation of mesangial IgA-nephropathy to WG is still unclear. This case underlines that knowledge of renal histology is essential in the management of patients with renal disease, especially in patients with hematuria and/or proeinuria with positive ANCA.
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Authors | L Joerg, A Kerstin, B Niko, A Dominik, K Martin, J Latus, K Amann, N Braun, M D Alscher, M Kimmel |
Journal | Minerva urologica e nefrologica = The Italian journal of urology and nephrology
(Minerva Urol Nefrol)
Vol. 64
Issue 2
Pg. 149-52
(Jun 2012)
ISSN: 0393-2249 [Print] Italy |
PMID | 22617309
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Antibodies, Antineutrophil Cytoplasmic
- Biomarkers
- Glucocorticoids
- Immunoglobulin A
- Immunologic Factors
- Immunosuppressive Agents
- Cyclophosphamide
- Prednisolone
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Topics |
- Antibodies, Antineutrophil Cytoplasmic
(blood)
- Biomarkers
(blood)
- Cyclophosphamide
(therapeutic use)
- Drug Therapy, Combination
- Follow-Up Studies
- Glomerulonephritis, IGA
(blood, diagnosis, drug therapy, immunology)
- Glucocorticoids
(therapeutic use)
- Granulomatosis with Polyangiitis
(blood, diagnosis, drug therapy, immunology)
- Humans
- Immunoglobulin A
(blood)
- Immunologic Factors
(blood)
- Immunosuppressive Agents
(therapeutic use)
- Male
- Middle Aged
- Prednisolone
(therapeutic use)
- Tomography, X-Ray Computed
- Treatment Outcome
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