Development of Myeloperoxidase Anti-neutrophil Cytoplasmic Antibody-positive Necrotizing Crescentic Glomerulonephritis in an Elderly Patient with Immunological Kidney Disease

A 78-year-old man presented with hypercalcemia and renal disease with high serum IgG4 and positive myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA), exhibiting sarcoidosis-like chest findings. A renal biopsy revealed tubulointerstitial nephritis, membranous nephropathy (MN), and sub-c...

Descripción completa

Detalles Bibliográficos
Autores principales: Yoshida, Haruyoshi, Takahashi, Naoki, Horiguchi, Takayasu, Yasuhara, Hiroki, Tanaka, Tokuharu, Chen, Yuhao, Takasaki, Toshikazu, Tsukao, Hitokazu, Yoshida, Michiko, Kawakami, Satoshi, Ohta, Makoto, Naiki, Hironobu, Konishi, Satoshi, Ito, Isao, Iwano, Masayuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8758455/
https://www.ncbi.nlm.nih.gov/pubmed/34148959
http://dx.doi.org/10.2169/internalmedicine.7252-21
Descripción
Sumario:A 78-year-old man presented with hypercalcemia and renal disease with high serum IgG4 and positive myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA), exhibiting sarcoidosis-like chest findings. A renal biopsy revealed tubulointerstitial nephritis, membranous nephropathy (MN), and sub-capsular lymphoid aggregates without fulfilling the diagnostic criteria of IgG4-related disease or sarcoidosis. Steroid therapy ameliorated the serological and renal abnormalities. After 5 years, following gradual increases in the neutrophil count and upper respiratory infection (URI), necrotizing crescentic glomerulonephritis (NCGN) developed with an increased serum MPO-ANCA level. These results suggest that in the presence of MPO-ANCA in immune senescence, the persistent neutrophil increase with URI may lead to the development of NCGN.

Ejemplares similares