Double-Positive Anti-GBM and ANCA-MPO Vasculitis Presenting With Crescentic Glomerulonephritis
| Autor: | Jorge Almeida, Clara Silva, Neuza Soares, João E Silva, Mariana Pacheco |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
imunossupression medicine.medical_treatment acute renal injury anti-gbm disease 030204 cardiovascular system & hematology urologic and male genital diseases Gastroenterology 03 medical and health sciences 0302 clinical medicine Rheumatology Internal medicine Internal Medicine medicine mpo-anca vasculitis Proteinuria medicine.diagnostic_test business.industry General Engineering Acute kidney injury Glomerulonephritis medicine.disease Transplantation crescentic glomerulonephritis Nephrology overlap anca and anti-gbm Plasmapheresis Hemodialysis Renal biopsy medicine.symptom Vasculitis business 030217 neurology & neurosurgery |
| Zdroj: | Cureus |
| ISSN: | 2168-8184 |
| DOI: | 10.7759/cureus.14806 |
| Popis: | We report the case of a 61-year-old man with rapidly progressing glomerulonephritis (RPGN) due to double-positive anti-neutrophil cytoplasmic antibodies (ANCA) and anti-glomerular basement membrane antibodies (GBM) vasculitis. The past medical history included stable untreated psoriatic arthritis and arterial hypertension. He presented with asthenia, anorexia, and rapidly deteriorating renal function with metabolic acidosis and hyperkalemia evolving with the need for hemodialysis. No nephrotoxic drugs were identified. Urinalysis showed proteinuria, erythrocyturia, and mild leukocyturia with no pathological casts and renal ultrasound excluded obstruction as the cause of the acute kidney injury. The subsequent study established the diagnosis of double-positive ANCA and anti-GBM vasculitis with renal biopsy confirming the presence of crescentic glomerulonephritis. The patient was started on corticosteroids, cyclophosphamide, and plasmapheresis with the improvement of symptoms and decrease of antibody titers. The renal function recovery was not obtained and referral for transplantation is ongoing. |
| Databáze: | OpenAIRE |
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