A Patient with MPO-ANCA-positive IgA Nephropathy Diagnosed with the Clinical Onset of Macrohematuria.

Abstract

A 21-year-old woman presented with renal dysfunction during macrohematuria. A kidney biopsy revealed IgA nephropathy with a small percentage of crescent formation and macrohematuria-associated tubular injury. Macrohematuria-associated acute kidney injury could explain her renal dysfunction. However, she was seropositive for myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA) and showed fibrin deposition around one arteriole. Corticosteroids and mycophenolate mofetil were administered as for ANCA vasculitis, and the serum creatinine, abnormal urinalysis and MPO-ANCA titer all gradually ameliorated. The presence of extra-glomerular vasculitis, which was probably induced by ANCA, suggested that MPO-ANCA was an exacerbating factor for her prolonged renal dysfunction. This condition has so far only rarely been addressed in ANCA-positive IgA nephropathy.

• Authors: Minoru Yasukawa, Sachiko Kitagawa, Ryo Togashi, Shinichiro Asakawa, Michito Nagura, Shigeyuki Arai, Osamu Yamazaki, Yoshifuru Tamura, Fukuo Kondo, Ryuji Ohashi, Shunya Uchida, Shigeru Shibata, Yoshihide Fujigaki
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 58 Issue 14 Pg. 2051-2056 (Jul 15 2019) ISSN: 1349-7235 [Electronic] Japan
• PMID: 30918194 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Antibodies, Antineutrophil Cytoplasmic

Topics

• Acute Kidney Injury (diagnosis, drug therapy)
• Adrenal Cortex Hormones (adverse effects, therapeutic use)
• Adult
• Antibodies, Antineutrophil Cytoplasmic (therapeutic use)
• Female
• Glomerulonephritis, IGA (diagnosis, drug therapy, pathology)
• Hematuria (chemically induced)
• Humans
• Treatment Outcome
• Young Adult