Progressive renal disease despite immunosuppressive therapy in a patient with Wegener s granulomatosis.
We present a patient with Morbus Wegener and crescentic glomerulonephritis. Treatment with cyclophosphamide and prednisolone resulted in the disappearance of signs and symptoms of systemic inflammation. However, renal function deteriorated. Renal biopsy showed evidence of continuing capillary necrosis. Renal function improved with added plasmapheresis treatment. This case report illustrates that in patients with vasculitis necrotizing glomerulonephritis may remain active despite immunosuppressive therapy, even in the absence of extrarenal disease activity.
Klein
I
I
Department of Internal Medicine, Slingeland Hospital, Kruisbergseweg 25, 7009 BL Doetinchem, the Netherlands.
Vervoort
G
G
Steenbergen
E
E
Wetzels
J
J
D000368:Aged; D003520:Cyclophosphamide / Q000627:therapeutic use; D018450:Disease Progression; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003520:Cyclophosphamide; D011239:Prednisolone; D014295:Trimethoprim