A case of proteinase 3-antineutrophil cytoplasmic antibody-positive Sjögren's syndrome complicated with interstitial nephritis.
A 65-year-old woman who had fever was admitted. Laboratory data showed renal tubular dysfunction, elevated C-reactive protein, soluble interleukin-2 receptor (sIL-2R), and IgG. Her blood showed proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) as well as antinuclear antibody and anti-Ro/SS-A antibody. Salivary gland and renal biopsy showed inflammatory infiltration of lymphocytes. A diagnosis of Sjögren's syndrome (SS) and interstitial nephritis was made. beta(2)-microglobulin, sIL-2R, IgG, and PR3-ANCA were decreased in response to medium-dose oral prednisolone. Antineutrophil cytoplasmic antibody could be a new marker for extraglandular features of SS. It would be beneficial for SS patients who have positive ANCA to investigate extraglandular lesions such as interstitial nephritis.
Shimoyama
Kumiko
K
Third Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. delph@hama-med.ac.jp
Ogawa
Noriyoshi
N
Dei
Yoshiaki
Y
Suzuki
Daisuke
D
Saito
Miwako
M
Hayashi
Hideharu
H
D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology*; D005260:Female; D006801:Humans; D053146:Myeloblastin / Q000276:immunology* / Q000378:metabolism; D009395:Nephritis, Interstitial / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D009504:Neutrophils / Q000201:enzymology / Q000276:immunology*; D011239:Prednisolone / Q000627:therapeutic use; D013902:Radiography, Thoracic; D012469:Salivary Glands / Q000473:pathology; D012859:Sjogren's Syndrome / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D019268:Antibodies, Antineutrophil Cytoplasmic; D011239:Prednisolone; D053146:Myeloblastin