[Unilateral diffuse pulmonary involvement in vasculitis with anti-neutrophil cytoplasmic antibodies and anti-glomerular basement membrane antibodies].
A previously healthy 51-year-old man, hospitalized because of fatigue and joint complaints, was found to have left-sided diffuse pulmonary infiltration and a rapid rise in creatinine concentration. Anti-neutrophil cytoplasmic antibodies (cANCA) and anti-glomerular basement antibodies (anti-GBM) were found in serum. Renal biopsy revealed extracapillary glomerulonephritis with diffuse half-moon formations. Immunohistology showed a diffuse granular pattern for immunoglobulin G, M and complement C3, without linear deposits. Immunosuppressive treatment combined with plasmapheresis brought about rapid clinical improvement and normalization of the lung involvement and renal function, as well as a fall in the cANCA titre. During a follow-up period of 5 years there has been no recurrence of symptoms, although the anti-GBM titre remained strongly positive and the cANCA titre twice rose to abnormal levels.
Dobos
G J
GJ
Abteilung Innere Medizin IV, Medizinische Klinik Universität, Freiburg.
Grotz
W
W
Gondolf
K B
KB
Rohrbach
R
R
Peter
H H
HH
Schollmeyer
P
P
D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies / Q000032:analysis*; D001485:Basement Membrane / Q000276:immunology; D015415:Biomarkers; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000175:diagnosis / Q000276:immunology; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007678:Kidney Glomerulus / Q000276:immunology; D008171:Lung Diseases / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000175:diagnosis* / Q000276:immunology; D014657:Vasculitis / Q000175:diagnosis / Q000276:immunology*
D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D015415:Biomarkers
Einseitige diffuse Lungenbeteiligung bei Vaskulitis mit Anti-Neutrophilen-Zytoplasma-Antikörpern sowie Antikörpern gegen glomeruläre Basalmembranen.