info:eu-repo/semantics/article
ANCA-Positive pauci-immune crescentic glomerulonephritis in a patient with systemic lupus erythematosus
Fecha
2017-10Registro en:
Herrera-Añazco, P., Velásquez-Castillo, P., Pacheco-Mendoza, J., Valenzuela-Rodriguez, G., & Asato-Higa, C. (2017). ANCA-Positive pauci-immune crescentic glomerulonephritis in a patient with systemic lupus erythematosus. Brazilian Journal of Nephrology, 39(4), 454-457.
10.5935/0101-2800.20170079
Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Autor
Herrera Añazco, Percy
Velásquez-Castillo, Percy
Pacheco Mendoza, Josmel
Valenzuela-Rodríguez, Germán
Asato-Higa, Carmen
Institución
Resumen
The pauci-immune crescentic glomerulonephritis (PICGN) is generally associated with small-vessel vasculitis with a few reported cases associated with other autoimmune diseases such as Systemic Lupus Erythematosus (SLE). We present the case of a female 34-year-old patient with acute kidney injury symptoms with indication for renal replacement therapy in the context of clinical SLE diagnosis. A kidney biopsy was conducted and it was found that most glomeruli showed some segmental sclerosis with synechia to the Bowman's capsule. 67% of the glomeruli had fibroepithelial crescents. Moreover, the interstitial space had a moderate lymphomononuclear infiltration and mild fibrosis. In the arterioles, there were walls thickened by subintimal sclerosis. Direct immunofluorescence detected limited IgM and C3 deposits in capillary loops and negative mensangium for IgG, IgA and C1q. A therapy using corticosteroids and intravenous cyclophosphamide was initiated with stable evolution. PICGN associated with SLE is a rare pathology with clinical presentation, varied evolution and without a standard medical treatment.