Simultaneous Occurrence of Sarcoidosis and Anti-neutrophil Cytoplasmic Antibody-associated Vasculitis in a Patient with Lung Cancer

• Published in: Internal Medicine Vol. 58; no. 22; pp. 3299 - 3304
• Main Authors: Tsuchiya, Kazuo, Karayama, Masato, Sato, Taichi, Yasui, Hideki, Hozumi, Hironao, Suzuki, Yuzo, Furuhashi, Kazuki, Enomoto, Noriyuki, Fujisawa, Tomoyuki, Nakamura, Yutaro, Inui, Naoki, Sugimura, Haruhiko, Yasuda, Hideo, Suda, Takafumi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.11.2019; Japan Science and Technology Agency
• Subjects: Adenocarcinoma; Adenocarcinoma of Lung - complications; Aged; anti-neutrophil cytoplasmic antibody-associated vasculitis; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - complications; Antibodies, Antineutrophil Cytoplasmic - immunology; Antineutrophil cytoplasmic antibodies; Biopsy; Case Report; crescentic glomerulonephritis; Female; Glomerulonephritis; Glomerulonephritis - etiology; Hematuria; Humans; Internal medicine; Lung cancer; Lung Neoplasms - complications; Lymph nodes; Lymphadenopathy; Nephritis; Nephritis, Interstitial - etiology; Neutrophils; Peroxidase; Prednisolone; Renal function; Sarcoidosis; Sarcoidosis - complications; Thorax; Vasculitis; lung cancer; adenocarcinoma; anti-neutrophil cytoplasmic antibody-associated vasculitis; sarcoidosis; crescentic glomerulonephritis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.3004-19

A 71-year-old woman with abnormal pulmonary shadows and multiple enlarged thoracic lymph nodes was diagnosed with stage IIB lung adenocarcinoma, pulmonary sarcoidosis, and sarcoidosis-associated lymphadenopathy after biopsies from multiple organ sites. She also had rapidly progressive renal dysfunction, microhematuria, and high myeloperoxidase anti-neutrophil cytoplasmic antibody (MPO-ANCA) concentrations. A renal biopsy revealed granulomatous tubulointerstitial nephritis and necrotizing glomerulonephritis with crescent formation. She was diagnosed with nephritis caused by both sarcoidosis and ANCA-associated vasculitis. Oral prednisolone was administered to treat her nephritis, resulting in improvement in both her renal dysfunction and her sarcoidosis-associated lymphadenopathy.