Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis

A 44-year-old woman was admitted due to gross hematuria and progressive renal dysfunction. Poststreptococcal acute glomerulonephritis (PSAGN) was suspected due to her elevated anti-streptolysin O and anti-streptokinase titers and hypocomplementemia. A renal biopsy showed crescent formation and endoc...

Descripción completa

Detalles Bibliográficos
Autores principales: Kamijo, Natsumi, Mii, Akiko, Aratani, Sae, Kashiwagi, Tetsuya, Oda, Takashi, Shimizu, Akira, Sakai, Yukinao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9593139/
https://www.ncbi.nlm.nih.gov/pubmed/35283378
http://dx.doi.org/10.2169/internalmedicine.8690-21
_version_ 1784815092659912704
author Kamijo, Natsumi
Mii, Akiko
Aratani, Sae
Kashiwagi, Tetsuya
Oda, Takashi
Shimizu, Akira
Sakai, Yukinao
author_facet Kamijo, Natsumi
Mii, Akiko
Aratani, Sae
Kashiwagi, Tetsuya
Oda, Takashi
Shimizu, Akira
Sakai, Yukinao
author_sort Kamijo, Natsumi
collection PubMed
description A 44-year-old woman was admitted due to gross hematuria and progressive renal dysfunction. Poststreptococcal acute glomerulonephritis (PSAGN) was suspected due to her elevated anti-streptolysin O and anti-streptokinase titers and hypocomplementemia. A renal biopsy showed crescent formation and endocapillary hypercellularity with neutrophil infiltrate. An immunofluorescence analysis showed granular immunoglobulin G and C3 deposition, suggesting immune-complex-type glomerulonephritis. However, myeloperoxidase anti-neutrophil cytoplasmic antibody (ANCA) was positive, and peritubular capillaritis was observed. Furthermore, citrullinated histone H3-positive neutrophils were detected as markers for neutrophil extracellular trap formation. Therefore, she was diagnosed with ANCA-associated vasculitis superimposed on PSAGN that was the main contributor to her progressive renal injury.
format Online
Article
Text
id pubmed-9593139
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher The Japanese Society of Internal Medicine
record_format MEDLINE/PubMed
spelling pubmed-95931392022-11-07 Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis Kamijo, Natsumi Mii, Akiko Aratani, Sae Kashiwagi, Tetsuya Oda, Takashi Shimizu, Akira Sakai, Yukinao Intern Med Case Report A 44-year-old woman was admitted due to gross hematuria and progressive renal dysfunction. Poststreptococcal acute glomerulonephritis (PSAGN) was suspected due to her elevated anti-streptolysin O and anti-streptokinase titers and hypocomplementemia. A renal biopsy showed crescent formation and endocapillary hypercellularity with neutrophil infiltrate. An immunofluorescence analysis showed granular immunoglobulin G and C3 deposition, suggesting immune-complex-type glomerulonephritis. However, myeloperoxidase anti-neutrophil cytoplasmic antibody (ANCA) was positive, and peritubular capillaritis was observed. Furthermore, citrullinated histone H3-positive neutrophils were detected as markers for neutrophil extracellular trap formation. Therefore, she was diagnosed with ANCA-associated vasculitis superimposed on PSAGN that was the main contributor to her progressive renal injury. The Japanese Society of Internal Medicine 2022-03-12 2022-10-01 /pmc/articles/PMC9593139/ /pubmed/35283378 http://dx.doi.org/10.2169/internalmedicine.8690-21 Text en Copyright © 2022 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Kamijo, Natsumi
Mii, Akiko
Aratani, Sae
Kashiwagi, Tetsuya
Oda, Takashi
Shimizu, Akira
Sakai, Yukinao
Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis
title Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis
title_full Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis
title_fullStr Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis
title_full_unstemmed Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis
title_short Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis Superimposed on Post-streptococcal Acute Glomerulonephritis
title_sort anti-neutrophil cytoplasmic antibody-associated vasculitis superimposed on post-streptococcal acute glomerulonephritis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9593139/
https://www.ncbi.nlm.nih.gov/pubmed/35283378
http://dx.doi.org/10.2169/internalmedicine.8690-21
work_keys_str_mv AT kamijonatsumi antineutrophilcytoplasmicantibodyassociatedvasculitissuperimposedonpoststreptococcalacuteglomerulonephritis
AT miiakiko antineutrophilcytoplasmicantibodyassociatedvasculitissuperimposedonpoststreptococcalacuteglomerulonephritis
AT aratanisae antineutrophilcytoplasmicantibodyassociatedvasculitissuperimposedonpoststreptococcalacuteglomerulonephritis
AT kashiwagitetsuya antineutrophilcytoplasmicantibodyassociatedvasculitissuperimposedonpoststreptococcalacuteglomerulonephritis
AT odatakashi antineutrophilcytoplasmicantibodyassociatedvasculitissuperimposedonpoststreptococcalacuteglomerulonephritis
AT shimizuakira antineutrophilcytoplasmicantibodyassociatedvasculitissuperimposedonpoststreptococcalacuteglomerulonephritis
AT sakaiyukinao antineutrophilcytoplasmicantibodyassociatedvasculitissuperimposedonpoststreptococcalacuteglomerulonephritis

Ejemplares similares