ANCA-associated crescentic IgA glomerulonephritis in pregnancy.
Only a few reports have documented the presence of crescentic IgA nephropathy associated with antineutrophil cytoplasmic antibodies (ANCA), suggesting an overlap that has therapeutic significance as regards the patients' response to treatment. We report a case of rapidly progressive glomerulonephritis with P-ANCA, with biopsyproven crescentic IgA glomerulonephritis in an 11-week pregnant woman who responded very well to cyclophosphamide and prednisone. Her 24-h urine protein dropped from 5400 mg/day to 516 mg/day and serum creatinine from 2.7 mg/dL to 1.4 mg/dL. To the best of our knowledge, this is the first such case reported in pregnancy. Eighteen months after her initial presentation, she has no significant clinical problems and her laboratory work-up shows stable results.
Amir
Abdul Razack A
AR
Internal Medicine Department, Pathology Division, Saudi Aramco, Dhahran Health Center, Dhahran, Saudi Arabia.
Sheikh
Salwa S
SS
D000032:Abortion, Therapeutic; D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis* / Q000276:immunology; D001707:Biopsy, Needle; D003520:Cyclophosphamide / Q000032:analysis; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007677:Kidney Function Tests; D008775:Methylprednisolone / Q000008:administration & dosage; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D011261:Pregnancy Trimester, First; D012720:Severity of Illness Index
D019268:Antibodies, Antineutrophil Cytoplasmic; D003520:Cyclophosphamide; D008775:Methylprednisolone