title: Case report - IgA nephropathy ANCA positive with favorable outcome.
abstract: BACKGROUND
  The antineutrophil cytoplasmatic antibody (ANCA) is usually associated with pauci-immune crescentic glomerulonephritis (CrGN). However, the literature show an incidence unexpected high of ANCA in immunocomplex CrNP. The crescent IgA nephropaty is one of CrGN that associated with ANCAObjective:To relate an IgA nephropaty ANCA positive and sign of worse prognosis that improved with immunossupression.
  
  
  METHODS
  38-year-old pacient with arterial hypertension, renal impairment (CKD-EPI 37 ml/min/1,73 m2), non-nephrotic proteinuria and hematuria. He related occasionally epistaxis, rhnosinusitis and one arthritis episode that spontaneously resolved. During de investigation, the ANCA titles were 1/160 and anti-RP3 was positive, however renal biopsy showed IgA nephropaty with 38% of crescents. Regarding IgA nephropaty ANCA positive as the main diagnosis, immunossupression therapy with corticoids (1g IV methilprednisone for 3 days followed by 1 mg/kg/day prednisone) for 6 months and cyclophosphamide (500 mg initially then raise the dose until reach 750 m2. The patient improved renal function and reduced the proteinuria and ANCA titulation.
  
  
  CONCLUSIONS
  The role of the association between IgA nephropathy and ANCA is it aggressive manifestation characterized by the presence of crescents, tubular atrophy and renal dysfunction, which may regress with early onset of immunosuppression treatment.
authors.affiliation: Unidade de Nefrologia, Hospital de Base do Distrito Federal, BR.
authors.forename: Flávia Lara
authors.initials: FL
authors.lastname: Barcelos
authors.affiliation: Unidade de Nefrologia, Hospital de Base do Distrito Federal, BR.
authors.forename: Tânia Maria de Souza
authors.initials: TM
authors.lastname: Fontes
mesh_terms: D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic; D005922:Glomerulonephritis, IGA / Q000188:drug therapy* / Q000276:immunology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D011241:Prednisone / Q000627:therapeutic use*; D012074:Remission Induction
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011241:Prednisone