Limits...
Antineutrophil cytoplasmic antibody-negative pauci-immune glomerulonephritis with massive intestinal bleeding.

Kim M, Kim YU, Boo SJ, Kim SM, Kim HW - Kidney Res Clin Pract (2015)

Bottom Line: On the 45(th) hospital day, the patient suddenly lost consciousness.Brain computed tomography showed intracerebral hemorrhage.We report a case of antineutrophil cytoplasmic antibody-negative pauci-immune glomerulonephritis with massive intestinal bleeding and cerebral hemorrhage.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.

ABSTRACT
A 61-year-old woman was admitted to hospital because of generalized edema and proteinuria. Her renal function deteriorated rapidly. Serum immunoglobulin and complement levels were within normal ranges. An autoantibody examination showed negative for antinuclear antibody and antineutrophil cytoplasmic antibody. Histologic examination of a renal biopsy specimen revealed that all of the glomeruli had severe crescent formations with no immune deposits. The patient was treated with steroid pulse therapy with cyclophosphamide followed by oral prednisolone. Fifteen days later, she experienced massive recurrent hematochezia. Angiography revealed an active contrast extravasation in a branch of the distal ileal artery. We selectively embolized with a permanent embolic agent. On the 45(th) hospital day, the patient suddenly lost consciousness. Brain computed tomography showed intracerebral hemorrhage. We report a case of antineutrophil cytoplasmic antibody-negative pauci-immune glomerulonephritis with massive intestinal bleeding and cerebral hemorrhage.

No MeSH data available.


Related in: MedlinePlus

Renal biopsy findings. (A) Histologic examination of a renal biopsy specimen reveals that the glomerulus has a severe crescent formation. (B) There are loop necrosis and fibrin deposition in the glomerular tufts. The tubules reveal focal moderate atrophy and loss with infiltration of mononuclear cells in edematous interstitium. Blood vessels are unremarkable. [Periodic acid-Schiff stain: (A) 400× and (B) 200×].
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4608877&req=5

f0005: Renal biopsy findings. (A) Histologic examination of a renal biopsy specimen reveals that the glomerulus has a severe crescent formation. (B) There are loop necrosis and fibrin deposition in the glomerular tufts. The tubules reveal focal moderate atrophy and loss with infiltration of mononuclear cells in edematous interstitium. Blood vessels are unremarkable. [Periodic acid-Schiff stain: (A) 400× and (B) 200×].

Mentions: The renal biopsy specimen showed cellular or fibrocellular crescentic formation in 92% (57/62) of glomeruli (Fig. 1). The tubules revealed focal moderate atrophy and loss with infiltration of mononuclear cells in edematous interstitium. Immunohistochemistry, using three glomeruli, demonstrated no staining for IgG, IgA, IgM, complements (C3, C1q), or fibrinogen. Electron microscopy also showed no dense deposits, with severe effacement of epithelial foot processes.


Antineutrophil cytoplasmic antibody-negative pauci-immune glomerulonephritis with massive intestinal bleeding.

Kim M, Kim YU, Boo SJ, Kim SM, Kim HW - Kidney Res Clin Pract (2015)

Renal biopsy findings. (A) Histologic examination of a renal biopsy specimen reveals that the glomerulus has a severe crescent formation. (B) There are loop necrosis and fibrin deposition in the glomerular tufts. The tubules reveal focal moderate atrophy and loss with infiltration of mononuclear cells in edematous interstitium. Blood vessels are unremarkable. [Periodic acid-Schiff stain: (A) 400× and (B) 200×].
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608877&req=5

f0005: Renal biopsy findings. (A) Histologic examination of a renal biopsy specimen reveals that the glomerulus has a severe crescent formation. (B) There are loop necrosis and fibrin deposition in the glomerular tufts. The tubules reveal focal moderate atrophy and loss with infiltration of mononuclear cells in edematous interstitium. Blood vessels are unremarkable. [Periodic acid-Schiff stain: (A) 400× and (B) 200×].
Mentions: The renal biopsy specimen showed cellular or fibrocellular crescentic formation in 92% (57/62) of glomeruli (Fig. 1). The tubules revealed focal moderate atrophy and loss with infiltration of mononuclear cells in edematous interstitium. Immunohistochemistry, using three glomeruli, demonstrated no staining for IgG, IgA, IgM, complements (C3, C1q), or fibrinogen. Electron microscopy also showed no dense deposits, with severe effacement of epithelial foot processes.

Bottom Line: On the 45(th) hospital day, the patient suddenly lost consciousness.Brain computed tomography showed intracerebral hemorrhage.We report a case of antineutrophil cytoplasmic antibody-negative pauci-immune glomerulonephritis with massive intestinal bleeding and cerebral hemorrhage.

View Article: PubMed Central - PubMed

Affiliation: Division of Nephrology, Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.

ABSTRACT
A 61-year-old woman was admitted to hospital because of generalized edema and proteinuria. Her renal function deteriorated rapidly. Serum immunoglobulin and complement levels were within normal ranges. An autoantibody examination showed negative for antinuclear antibody and antineutrophil cytoplasmic antibody. Histologic examination of a renal biopsy specimen revealed that all of the glomeruli had severe crescent formations with no immune deposits. The patient was treated with steroid pulse therapy with cyclophosphamide followed by oral prednisolone. Fifteen days later, she experienced massive recurrent hematochezia. Angiography revealed an active contrast extravasation in a branch of the distal ileal artery. We selectively embolized with a permanent embolic agent. On the 45(th) hospital day, the patient suddenly lost consciousness. Brain computed tomography showed intracerebral hemorrhage. We report a case of antineutrophil cytoplasmic antibody-negative pauci-immune glomerulonephritis with massive intestinal bleeding and cerebral hemorrhage.

No MeSH data available.


Related in: MedlinePlus