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A typical Wegeners granulomatosis - but not pauci-immune!
MedLine Citation:
PMID:  22617309     Owner:  NLM     Status:  In-Data-Review    
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.
L Joerg; A Kerstin; B Niko; A Dominik; K Martin; J Latus; K Amann; N Braun; M D Alscher; M Kimmel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Minerva urologica e nefrologica = The Italian journal of urology and nephrology     Volume:  64     ISSN:  0393-2249     ISO Abbreviation:  Minerva Urol Nefrol     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503649     Medline TA:  Minerva Urol Nefrol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  149-52     Citation Subset:  IM    
Division of Nephrology, Department of Internal Medicine, Robert-Bosch Hospital, Stuttgart, Germany -
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