Rapidly progressive glomerulonephritis secondary to pauci-immune vasculitis, a rare entity: Case report and review of the literature
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Case report
acute kidney injury
C3 glomerulonephritis
renal biopsy

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Giraldo Ocampo CC, Jimenez Bejarano MF, Serna Flórez J. Rapidly progressive glomerulonephritis secondary to pauci-immune vasculitis, a rare entity: Case report and review of the literature. Rev. Colomb. Nefrol. [Internet]. 2022 Jul. 21 [cited 2024 Jul. 16];9(2). Available from: https://revistanefrologia.org/index.php/rcn/article/view/555


Introduction: Vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA) are a heterogeneous group of pathologies; characterized by the inflammation and destruction of small and medium caliber blood vessels associated with the presence of circulating ANCA. They present with a wide variety of signs and symptoms and, if left untreated, lead to high morbidity and mortality; They are a rare cause of rapidly progressive glomerulonephritis and acute kidney injury requiring renal support, which is why a high index of suspicion is required in the initial approach.

Purpose:  This article seeks to sensitize the medical personnel for the need of an active search for vasculitis as a cause of glomerulonephritis and the impact of early diagnosis and treatment in the patient's clinical condition.

Case presentation: We report the case of a 65-year-old male patient treated in a reference hospital in the city of Pereira, Risaralda, who debuted with rapidly progressive glomerulonephritis secondary to microscopic polyangiitis in his postoperative period of a prostatectomy, progressing to acute kidney injury needing to start renal support such as intermittent hemodialysis; after performing a renal biopsy and autoimmunity profile, the diagnosis of microscopic polyangiitis-type vasculitis is confirmed, specific immunosuppressive management is initiated, which achieves remission of the disease and with it an improvement in renal function that allows the suspension of renal replacement therapy, y, currently a patient He remains asymptomatic, with remission, with immunosuppressive management, attending outpatient controls with nephrology without mention of complications secondary to pharmacological therapy.

Discussion and conclusion: In antineutrophil cytoplasmic antibody(ANCA)-Associated Vasculitis , timely diagnosis and the establishment of adequate immunomodulatory therapy are the fundamental pillars in the approach to this entity. A late diagnosis is directly related to a poor short-term prognosis. Timely diagnosis requires an appropriate index of suspicion.

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Geetha D, Jefferson JA. ANCA-Associated Vasculitis: Core Curriculum 2020. Am J Kidney Dis. 2020;75(1):124-37. https://doi.org/10.1053/j.ajkd.2019.04.031

Jain V, Tiwari V. Microscopic Polyangiitis. StatPearls. Treasure Island, Florida: StatPearls Publishing; 2020.

Yates M, Watts R. ANCA-associated vasculitis. Clin Med. 2017;17(1):60-4. https://doi.org/10.7861/clinmedicine.17-1-60

Watts RA, Mahr A, Mohammad AJ, Gatenby P, Basu N, Flores-Suárez LF. Classification, epidemiology and clinical subgrouping of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Nephrol Dial Transplant. 2015;30 supl. 1:i14-22. https://doi.org/10.1093/ndt/gfv022

Berti A, Cornec D, Crowson CS, Specks U, Matteson EL. The Epidemiology of Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis in Olmsted County, Minnesota: A Twenty-Year US Population-Based Study. Arthritis Rheum. 2017;69(12):2338-50. https://doi.org/10.1002/art.40313

Moiseev S, Cohen-Tervaert JW, Arimura Y, Bogdanos DP, Csernok E, Damoiseaux J, et al. 2020 International consensus on ANCA testing beyond systemic vasculitis. Autoimmun Rev. 2020;19(9):102618. https://doi.org/10.1016/j.autrev.2020.102618

Binda V, Moroni G, Messa P. ANCA-associated vasculitis with renal involvement. J Nephrol. 2018;31(2):197-208. https://doi.org/10.1007/s40620-017-0412-z

Han Y, Ma FY, Tesch GH, Manthey CL, Nikolic-Paterson DJ. Role of macrophages in the fibrotic phase of rat crescentic glomerulonephritis. Am J Physiol-Renal Physiol. 2013;304(8):F1043-53. https://doi.org/10.1152/ajprenal.00389.2012

Sethi S, Zand L, De Vriese AS, Specks U, Vrana JA, Kanwar S, et al. Complement activation in pauci-immune necrotizing and crescentic glomerulonephritis: results of a proteomic analysis. Nephrol Dial Transplant. 2017;32(supl. 1):i139-45. https://doi.org/10.1093/ndt/gfw299

Karras A. Microscopic Polyangiitis: New Insights into Pathogenesis, Clinical Features and Therapy. Semin Respir Crit Care Med. 2018;39(4):459-64. https://doi.org/10.1055/s-0038-1673387

Wallace ZS, Miloslavsky EM. Management of ANCA associated vasculitis. BMJ. 2020;368:m421. https://doi.org/10.1136/bmj.m421

Atanov PV, Geetha D, Jefferson JA. ANCA-Associated Vasculitis: Core Curriculum 2020. Arkhiv patologii. 2020;75(1):124-37. https://doi.org/10.1053/j.ajkd.2019.04.031

Jennette JC, Nachman PH. ANCA Glomerulonephritis and Vasculitis. Clin J Am Soc Nephrol. 2017;12(10):1680-91. https://doi.org/10.2215/CJN.02500317

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