Interstitial nephritis and high titers of PR3-ANCA: an unusual manifestation of ANCA-associated disease.
We present the case of a 75-year-old female with weight loss, anemia, systemic signs of inflammation, mild renal insufficiency, microscopic hematuria, mixed glomerular and tubular proteinuria, and high titers of PR3-ANCA. Renal biopsy demonstrated interstitial nephritis with some sclerosed but otherwise normal glomeruli. Extensive work-up showed no signs of granulomatous inflammation or other vasculitic organ involvement. We presumed this to be a rare renal manifestation of ANCA-associated disease with the presence of sclerosed glomeruli suggesting a previous history of glomerular involvement. In view of the absence of active vasculitic or granulomatous disease, treatment was limited to low-dose corticosteroids with good response.
Schönermarck
U
U
Nephrology Department, Medical Clinic I, University Hospital München-Grosshadern, LMU München, Germany. Ulf.Schoenermarck@med.uni-muenchen.de
Schirren
C A
CA
Mistry-Burchardi
N
N
Weiss
M
M
Eichhorn
P
P
Samtleben
W
W
D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D005260:Female; D006801:Humans; D053146:Myeloblastin; D009395:Nephritis, Interstitial / Q000097:blood*; D012697:Serine Endopeptidases / Q000097:blood*
D019268:Antibodies, Antineutrophil Cytoplasmic; D012697:Serine Endopeptidases; D053146:Myeloblastin