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cANCA-associated aortitis.

Amos LA, Roberts MA, Blair S, McMahon LP - Clin Kidney J (2012)

Bottom Line: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is traditionally viewed as a small vessel disease.We report a patient with cANCA antibodies directed against proteinase-3 with asymptomatic aortic involvement, in combination with diffuse alveolar haemorrhage and pauci-immune, necrotizing crescentic glomerulonephritis.A review of the literature is discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Renal Medicine, Monash University and Eastern Health, Melbourne, Australia.

ABSTRACT
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is traditionally viewed as a small vessel disease. We report a patient with cANCA antibodies directed against proteinase-3 with asymptomatic aortic involvement, in combination with diffuse alveolar haemorrhage and pauci-immune, necrotizing crescentic glomerulonephritis. A review of the literature is discussed.

No MeSH data available.


Related in: MedlinePlus

(A) CT scan showing periaortic oedema of the abdominal aorta at diagnosis. (B) CT scan of abdominal aorta at 2 months (inflammation indicated by arrowheads).
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fig1: (A) CT scan showing periaortic oedema of the abdominal aorta at diagnosis. (B) CT scan of abdominal aorta at 2 months (inflammation indicated by arrowheads).

Mentions: A 64-year-old Greek man, previously well, presented with a 4-week history of fever, malaise, dysuria and haematuria. He described intermittent pleuritic chest pain but no abdominal pain. A trial of antibiotics (roxithromycin and cephalexin) from his local doctor had not improved his symptoms. At presentation, he was normotensive. Relevant physical findings included crackles at the left lower lung field and minimal oedema in the lower extremities. Initial laboratory investigations demonstrated a serum creatinine of 92 μmol/L, with elevated inflammatory markers (C-reactive protein 29 mg/L; erythrocyte sedimentation rate 93 mm/h). Initial urine microscopy revealed heavy isomorphic haematuria without cellular casts and an Escherichia coli infection on culture. After treatment of the infection, urine microscopy demonstrated >1000 × 106/L dysmorphic red cells and 24-h urine collection revealed significant proteinuria (1.05 g/day), with a creatinine clearance of 33 mL/min. A blurred outline of the abdominal aorta was revealed on computerized tomography (CT) scan, and subsequent CT aortogram revealed near circumferential soft tissue oedema of both the thoracic arch and inferior to the origin of the renal arteries. There was no narrowing or obliteration of the vessel lumen (Figure 1a).


cANCA-associated aortitis.

Amos LA, Roberts MA, Blair S, McMahon LP - Clin Kidney J (2012)

(A) CT scan showing periaortic oedema of the abdominal aorta at diagnosis. (B) CT scan of abdominal aorta at 2 months (inflammation indicated by arrowheads).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400447&req=5

fig1: (A) CT scan showing periaortic oedema of the abdominal aorta at diagnosis. (B) CT scan of abdominal aorta at 2 months (inflammation indicated by arrowheads).
Mentions: A 64-year-old Greek man, previously well, presented with a 4-week history of fever, malaise, dysuria and haematuria. He described intermittent pleuritic chest pain but no abdominal pain. A trial of antibiotics (roxithromycin and cephalexin) from his local doctor had not improved his symptoms. At presentation, he was normotensive. Relevant physical findings included crackles at the left lower lung field and minimal oedema in the lower extremities. Initial laboratory investigations demonstrated a serum creatinine of 92 μmol/L, with elevated inflammatory markers (C-reactive protein 29 mg/L; erythrocyte sedimentation rate 93 mm/h). Initial urine microscopy revealed heavy isomorphic haematuria without cellular casts and an Escherichia coli infection on culture. After treatment of the infection, urine microscopy demonstrated >1000 × 106/L dysmorphic red cells and 24-h urine collection revealed significant proteinuria (1.05 g/day), with a creatinine clearance of 33 mL/min. A blurred outline of the abdominal aorta was revealed on computerized tomography (CT) scan, and subsequent CT aortogram revealed near circumferential soft tissue oedema of both the thoracic arch and inferior to the origin of the renal arteries. There was no narrowing or obliteration of the vessel lumen (Figure 1a).

Bottom Line: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is traditionally viewed as a small vessel disease.We report a patient with cANCA antibodies directed against proteinase-3 with asymptomatic aortic involvement, in combination with diffuse alveolar haemorrhage and pauci-immune, necrotizing crescentic glomerulonephritis.A review of the literature is discussed.

View Article: PubMed Central - PubMed

Affiliation: Department of Renal Medicine, Monash University and Eastern Health, Melbourne, Australia.

ABSTRACT
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is traditionally viewed as a small vessel disease. We report a patient with cANCA antibodies directed against proteinase-3 with asymptomatic aortic involvement, in combination with diffuse alveolar haemorrhage and pauci-immune, necrotizing crescentic glomerulonephritis. A review of the literature is discussed.

No MeSH data available.


Related in: MedlinePlus