Myeloperoxidase Antineutrophil Cytoplasmic Antibody (MPO-ANCA) Associated Crescentic and Necrotizing Glomerulonephritis (GN) with Membranoproliferative GN Features

A 77-year-old man presented with a fever, non-productive cough, and edema formation. A laboratory analysis showed an elevated creatinine level (2.5 mg/dL), a high titer of myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA) (99 U/mL), positive reaction for antinuclear antibody (×320),...

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Bibliographic Details
Published in:Internal Medicine 2016/08/01, Vol.55(15), pp.2043-2048
Main Authors: Koda, Ryo, Nagahori, Katsuhiro, Kitazawa, Atsushi, Imanishi, Yuji, Yoshino, Atsunori, Kawamoto, Shinya, Ueda, Yoshihiko, Takeda, Tetsuro
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - therapeutic use
Aged
Antibodies, Antineutrophil Cytoplasmic - analysis
antineutrophil cytoplasmic antibody (ANCA)
antinuclear antibody (ANA)
crescentic glomerulonephritis
Glomerulonephritis - drug therapy
Glomerulonephritis - immunology
Glomerulonephritis - pathology
Glomerulonephritis, Membranoproliferative - drug therapy
Glomerulonephritis, Membranoproliferative - immunology
Glomerulonephritis, Membranoproliferative - pathology
Humans
Immunosuppressive Agents - therapeutic use
Male
membranoproliferative glomerulonephritis
myeloperoxidase (MPO)
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Summary:A 77-year-old man presented with a fever, non-productive cough, and edema formation. A laboratory analysis showed an elevated creatinine level (2.5 mg/dL), a high titer of myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA) (99 U/mL), positive reaction for antinuclear antibody (×320), hematuria, and massive proteinuria (3.33 g/day). A renal biopsy revealed crescentic and necrotizing glomerulonephritis (GN) with membranoproliferative GN features [double contour appearance of the glomerular basement membrane, granular deposition of immunoglobulin (Ig) G, IgM, and C3 along the capillary wall, subendothelial and subepithelial deposits with mesangial interposition]. A potential relationship between MPO-ANCA associated GN and membranoproliferative GN is discussed.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.6426