title: Lateral medullary stroke in patient with granulomatous polyangiitis.
abstract: Granulomatous polyangiitis (GPA), also known as Wegener granulomatosis, is a systemic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis that infrequently affects the central nervous system. We report a 41-year-old man with lateral medullary infarction who developed rapidly progressive renal failure. He was diagnosed with GPA based on positive serum c-ANCA and antiproteinase 3 antibodies and demonstration of pauci-immune crescentic glomerulonephritis on kidney biopsy. He was treated with Coumadin, pulse steroids, cyclophosphamide, and plasmapheresis. He had resolution of his neurologic deficits and improvement in renal function. This case report highlights the importance to consider GPA vasculitis in the differential diagnosis of stroke in patients with development of acute kidney injury.
authors.affiliation: Department of Neurology, Albany Medical Center, Albany, New York. Electronic address: tarasco@mail.amc.edu.
authors.forename: Olga D
authors.initials: OD
authors.lastname: Taraschenko
authors.affiliation: Department of Neurology, Albany Medical Center, Albany, New York.
authors.forename: Colum F
authors.initials: CF
authors.lastname: Amory
authors.affiliation: Department of Medicine, Division of Nephrology, Albany Medical Center, Albany, New York.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Waldman
authors.affiliation: Department of Neurology, Albany Medical Center, Albany, New York.
authors.forename: Era K
authors.initials: EK
authors.lastname: Hanspal
authors.affiliation: Department of Neurology, Albany Medical Center, Albany, New York; Department of Neurology and Neurosurgery, Albany Medical Center, Albany, New York.
authors.forename: Gary L
authors.initials: GL
authors.lastname: Bernardini
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001706:Biopsy; D020526:Brain Stem Infarctions / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003937:Diagnosis, Differential; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D010956:Plasmapheresis; D011237:Predictive Value of Tests; D051437:Renal Insufficiency / Q000209:etiology; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D007166:Immunosuppressive Agents
keywords: Stroke; Wegener granulomatosis; granulomatous polyangiitis; kidney injury; medulla oblongata