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Anti-neutrophil cytoplasmic antibody vasculitis presenting with bilateral renal vein thrombosis.

Wlodek C, Robson MG - Clin Kidney J (2012)

Bottom Line: We report a case of anti-neutrophil cytoplasmic antibody (ANCA)-associated necrotizing crescentic glomerulonephritis presenting with bilateral renal vein thrombosis and pulmonary emboli in a patient who also had a lupus anticoagulant and anti-cardiolipin antibodies.Although the link between venous thrombosis and ANCA vasculitis is well established, the coexistence of renal vein thrombosis is unusual.Furthermore, despite the positive ANCA, he was initially negative for antibodies to myeloperoxidase (MPO) and proteinase-3 (PR3), illustrating that a positive ANCA may be significant despite a negative test for antibodies to MPO and PR3.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology and Transplantation, Guy's and St. Thomas' NHS Foundation Trust, London, UK.

ABSTRACT
We report a case of anti-neutrophil cytoplasmic antibody (ANCA)-associated necrotizing crescentic glomerulonephritis presenting with bilateral renal vein thrombosis and pulmonary emboli in a patient who also had a lupus anticoagulant and anti-cardiolipin antibodies. Although the link between venous thrombosis and ANCA vasculitis is well established, the coexistence of renal vein thrombosis is unusual. Furthermore, despite the positive ANCA, he was initially negative for antibodies to myeloperoxidase (MPO) and proteinase-3 (PR3), illustrating that a positive ANCA may be significant despite a negative test for antibodies to MPO and PR3.

No MeSH data available.


Related in: MedlinePlus

Computed tomography with contrast showing thrombus within both renal veins (white arrows).
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fig1: Computed tomography with contrast showing thrombus within both renal veins (white arrows).

Mentions: A 24-year-old Afro-Caribbean man presented with a 4-week history of fever, night sweats and abdominal pain associated with some weight loss and loose stools. On admission, his serum creatinine was 220 μmol/L with a urine protein–creatinine ratio (PCR) of 306 mg/mmol. The serum albumin was 34 g/L and C-reactive protein (CRP) was raised at 121 mg/L. His urinalysis revealed haematuria (4+) and he had an atypical ANCA but was negative for antibodies to both myeloperoxidase (MPO) and proteinase-3 (PR3). Serum protein electrophoresis showed a reduced albumin but no increase in α2-macroglobulin or other abnormality. A renal ultrasound showed normal-sized kidneys, and in view of his fever and abdominal pain, he underwent a computed tomography scan. Unexpectedly, this revealed bilateral pulmonary emboli and bilateral renal vein thrombosis as shown in Figure 1.


Anti-neutrophil cytoplasmic antibody vasculitis presenting with bilateral renal vein thrombosis.

Wlodek C, Robson MG - Clin Kidney J (2012)

Computed tomography with contrast showing thrombus within both renal veins (white arrows).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400499&req=5

fig1: Computed tomography with contrast showing thrombus within both renal veins (white arrows).
Mentions: A 24-year-old Afro-Caribbean man presented with a 4-week history of fever, night sweats and abdominal pain associated with some weight loss and loose stools. On admission, his serum creatinine was 220 μmol/L with a urine protein–creatinine ratio (PCR) of 306 mg/mmol. The serum albumin was 34 g/L and C-reactive protein (CRP) was raised at 121 mg/L. His urinalysis revealed haematuria (4+) and he had an atypical ANCA but was negative for antibodies to both myeloperoxidase (MPO) and proteinase-3 (PR3). Serum protein electrophoresis showed a reduced albumin but no increase in α2-macroglobulin or other abnormality. A renal ultrasound showed normal-sized kidneys, and in view of his fever and abdominal pain, he underwent a computed tomography scan. Unexpectedly, this revealed bilateral pulmonary emboli and bilateral renal vein thrombosis as shown in Figure 1.

Bottom Line: We report a case of anti-neutrophil cytoplasmic antibody (ANCA)-associated necrotizing crescentic glomerulonephritis presenting with bilateral renal vein thrombosis and pulmonary emboli in a patient who also had a lupus anticoagulant and anti-cardiolipin antibodies.Although the link between venous thrombosis and ANCA vasculitis is well established, the coexistence of renal vein thrombosis is unusual.Furthermore, despite the positive ANCA, he was initially negative for antibodies to myeloperoxidase (MPO) and proteinase-3 (PR3), illustrating that a positive ANCA may be significant despite a negative test for antibodies to MPO and PR3.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology and Transplantation, Guy's and St. Thomas' NHS Foundation Trust, London, UK.

ABSTRACT
We report a case of anti-neutrophil cytoplasmic antibody (ANCA)-associated necrotizing crescentic glomerulonephritis presenting with bilateral renal vein thrombosis and pulmonary emboli in a patient who also had a lupus anticoagulant and anti-cardiolipin antibodies. Although the link between venous thrombosis and ANCA vasculitis is well established, the coexistence of renal vein thrombosis is unusual. Furthermore, despite the positive ANCA, he was initially negative for antibodies to myeloperoxidase (MPO) and proteinase-3 (PR3), illustrating that a positive ANCA may be significant despite a negative test for antibodies to MPO and PR3.

No MeSH data available.


Related in: MedlinePlus