[IgA nephropathy with crescentic glomerulonephritis and ANCA positive].
We present a case of IgA nephropathy diagnosed by renal biopsy that presents after 2 years of folow-up an impairment of the renal function associate histoligically to a crescentic glomerulonephritis. The immunologic determinations showed of high titers of antineutrophil cytoplamic antibodies (ANCA) (P-ANCA IgG antiMPO and P-ANCA IgA anti-MPO). The patient began treatment with haemodyalisis and one year later she received a cadaveric kidney transplantation with good result. Two years later she had normal urine sediment, negative proteinuria, normal renal function but high titers of IgG and IgA PANCA anti-MPO. In summary, we believe that the determination ANCA in acute renal failure due to IgA nephropathy can indicate the existence of a IgA crescentic glomerulonephritis superimposed or an associated small vessel vasculitis and it confers a worse prognosis. The positive maintenance of IgG P-ANCA anti-MPO IgG anti-MPO titers during the course suggests that the sequential determination of ANCA in this entity is not useful to the monitoring of the clinical activity.
Ara
J
J
Servei de Nefrologia, Hospital Universitari Germans Trias i Pujol, Badalona. jara@ns.hugtip.scs.es
Bonet
J
J
Rodríguez
R
R
Mirapeix
E
E
Agraz
I
I
Romero
R
R
D000293:Adolescent; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology; D005922:Glomerulonephritis, IGA / Q000097:blood* / Q000150:complications*; D006801:Humans
D019268:Antibodies, Antineutrophil Cytoplasmic