title: Crescentic glomerulonephritis and elevated antimyeloperoxidase antibody in a patient with Churg-Strauss syndrome.
abstract: A 45-year-old man with a long history of bronchial asthma was admitted to the National Cardiovascular Center with complaints of severe pain, swelling, and ecchymoses of the lower extremities. A diagnosis of Churg-Strauss syndrome was made because of marked eosinophilia, vasculitis, and a history of asthma. Urinalysis revealed severe proteinuria and microscopic hematuria. A renal biopsy demonstrated extensively crescentic glomerulonephritis. The antineutrophil cytoplasmic antibody against myeloperoxidase (MPO-ANCA) level, determined by enzyme-linked immunosorbent assay (ELISA), was 494 ELISA units. Under treatment with prednisolone, the symptoms and eosinophilia improved within 3 days. The MPO-ANCA level decreased to its lowest value, and renal function was ameliorated within 3 months. The patient has been followed regularly on an ambulatory basis with a regimen of prednisolone.
authors.affiliation: Department of Internal Medicine, National Cardiovascular Center, Osaka, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Minami
authors.forename: H
authors.initials: H
authors.lastname: Ishibashi-Ueda
authors.forename: Y
authors.initials: Y
authors.lastname: Okano
authors.forename: T
authors.initials: T
authors.lastname: Inenaga
authors.forename: N
authors.initials: N
authors.lastname: Nakanishi
authors.forename: T
authors.initials: T
authors.lastname: Kunieda
authors.forename: C
authors.initials: C
authors.lastname: Yutani
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology; D001772:Blood Cell Count; D015267:Churg-Strauss Syndrome / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay; D005921:Glomerulonephritis / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000276:immunology*; D011239:Prednisolone / Q000627:therapeutic use; D012867:Skin / Q000473:pathology
chemical_list: D000893:Anti-Inflammatory Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D011239:Prednisolone; D009195:Peroxidase