Granulomatosis With Polyangiitis: A Pauci-Immune Rapidly Progressive Glomerulonephritis With Isolated Renal Involvement in an Elderly Male

被引：0

作者：

Mir, Wasey Ali Yadullahi ^{[1
]}

Shrestha, Dhan B. ^{[2
]}

Reddy, Vijay K. ^{[1
]}

Adhikari, Anurag ^{[3
]}

Verda, Larissa ^{[1
]}

机构：

[1] Mt Sinai Hosp, Internal Med, Chicago, IL USA

[2] Mt Sinai Hosp, Med, Chicago, IL 60608 USA

[3] Nepal Korea Friendship Municipal Hosp, Intens Care Unit, Madhyapur Thimi, Nepal

来源：

CUREUS JOURNAL OF MEDICAL SCIENCE | 2021年 / 13卷 / 08期

关键词：

wegener's granulomatosis; antineutrophil cytoplasmic antibodies; granulomatosis with polyangiitis; glomerulonephritis; abdominal pain; WEGENERS-GRANULOMATOSIS;

D O I：

10.7759/cureus.17098

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Granulomatosis with polyangiitis (GPA) is a necrotizing vasculitis with upper and lower respiratory tract and renal system involvement. We present a case of a 59-year-old male presenting with complaints of abdominal pain with deranged renal function and acute increase in creatinine level. On investigation, the antineutrophil cytoplasmic autoantibody, cytoplasmic (c-ANCA) was found to be significantly elevated in association with pauci-immune crescentic glomerulonephritis on biopsy. This was diagnostic of Wegener's granulomatosis. He was treated with intravenous cyclophosphamide 10 mg/kg/pulse along with steroids at 1 mg/kg/day for induction and trimethoprim/sulfamethoxazole (TMP-SMX) 80/400 mg for pneumocystis carinii pneumonia (PCP) prophylaxis after a negative tuberculosis QuantiFERON (R) assay (Qiagen, Netherlands). On discharge, he was on TMP-SMX prophylaxis for PCP, prednisone 60 mg daily, and cyclophosphamide on pulse dosing every 14 days with instructions to follow up. The patient showed improvement in therapy.

引用

页数：7

共 12 条

[1] Multiple renal masses as initial manifestation of Wegener's granulomatosis [J].

Carazo, ER ;

Benitez, AM ;

Milena, GL ;

Espigares, JR ;

León, L ;

Marquez, B .

AMERICAN JOURNAL OF ROENTGENOLOGY, 2001, 176 (01) :116-118

[2] Wegener's granulomatosis in a middle-aged woman presenting with dyspnea, rash, hemoptysis and recurrent eye complaints: A case report [J].

Jose Cardenas-Garcia ;

Dimitrios Farmakiotis ;

Berta-Paola Baldovino ;

Peter Kim .

Journal of Medical Case Reports, 6 (1)

[3] WEGENERS GRANULOMATOSIS - PROSPECTIVE CLINICAL AND THERAPEUTIC EXPERIENCE WITH 85 PATIENTS FOR 21 YEARS [J].

FAUCI, AS ;

HAYNES, BF ;

KATZ, P ;

WOLFF, SM .

ANNALS OF INTERNAL MEDICINE, 1983, 98 (01) :76-85

[4] A Case of Granulomatosis with Polyangiitis (Wegener's Granulomatosis) Presenting with Rapidly Progressive Glomerulonephritis [J].

Hasan, Md Rockyb ;

Sakibuzzaman, Md ;

Tabassum, Tahsin ;

Moosa, Sycd Ahmad .

CUREUS JOURNAL OF MEDICAL SCIENCE, 2019, 11 (10)

[5] WEGENER GRANULOMATOSIS - AN ANALYSIS OF 158 PATIENTS [J].

HOFFMAN, GS ;

KERR, GS ;

LEAVITT, RY ;

HALLAHAN, CW ;

LEBOVICS, RS ;

TRAVIS, WD ;

ROTTEM, M ;

FAUCI, AS .

ANNALS OF INTERNAL MEDICINE, 1992, 116 (06) :488-498

[6] 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides [J].

Jennette, J. C. ;

Falk, R. J. ;

Bacon, P. A. ;

Basu, N. ;

Cid, M. C. ;

Ferrario, F. ;

Flores-Suarez, L. F. ;

Gross, W. L. ;

Guillevin, L. ;

Hagen, E. C. ;

Hoffman, G. S. ;

Jayne, D. R. ;

Kallenberg, C. G. M. ;

Lamprecht, P. ;

Langford, C. A. ;

Luqmani, R. A. ;

Mahr, A. D. ;

Matteson, E. L. ;

Merkel, P. A. ;

Ozen, S. ;

Pusey, C. D. ;

Rasmussen, N. ;

Rees, A. J. ;

Scott, D. G. I. ;

Specks, U. ;

Stone, J. H. ;

Takahashi, K. ;

Watts, R. A. .

ARTHRITIS AND RHEUMATISM, 2013, 65 (01) :1-11

[7] THE AMERICAN-COLLEGE-OF-RHEUMATOLOGY 1990 CRITERIA FOR THE CLASSIFICATION OF WEGENER GRANULOMATOSIS [J].

LEAVITT, RY ;

FAUCI, AS ;

BLOCH, DA ;

MICHEL, BA ;

HUNDER, GG ;

AREND, WP ;

CALABRESE, LH ;

FRIES, JF ;

LIE, JT ;

LIGHTFOOT, RW ;

MASI, AT ;

MCSHANE, DJ ;

MILLS, JA ;

STEVENS, MB ;

WALLACE, SL ;

ZVAIFLER, NJ .

ARTHRITIS AND RHEUMATISM, 1990, 33 (08) :1101-1107

[8] A Case of Granulomatosis with Polyangiitis (Wegener's Granulomatosis) Presenting with Marked Inflamed Tracheobronchial Mucosa [J].

Nishiuma, Teruaki ;

Ohnishi, Hisashi ;

Yoshimura, Sho ;

Kinami, Saori ;

Sakamoto, Susumu .

CASE REPORTS IN MEDICINE, 2013, 2013

[9] Small vessel vasculitis of the lung [J].

Schwarz, MI ;

Brown, KK .

THORAX, 2000, 55 (06) :502-510

[10] Wegener granulomatosis: Case report and brief literature review [J].

Shafiei, K ;

Luther, E ;

Archie, M ;

Gulick, J ;

Fowler, MR .

JOURNAL OF THE AMERICAN BOARD OF FAMILY PRACTICE, 2003, 16 (06) :555-559

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