CLINICOPATHOLOGICAL INVESTIGATION OF P-ANCA POSITIVE CRESCENTIC GLOMERULONEPHRITIS

• Published in: Japanese Journal of National Medical Services Vol. 48; no. 11; pp. 945 - 949
• Main Authors: NOGUCHI, Yosihiko, TSUCHIDA, Hiroki, SUZUKI, Satoshi, NOZAKI, Osamu, HAMAGUCHI, Kinichi, NAKAYAMA, Masaaki
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1994
• Subjects: crescentic glomerulonephritis; p-ANCA
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.48.945

Five patients whose serologic test for p-ANCA (perinuclear pattern of anti-neutro-phil cytoplasmic antigen) was positive were treated at Sakura National Hospital. Fever and elevated CRP level were observed in all patients. And many clinical manifestations suggesting angiitis were noted such as pulmonaly bleeding in two cases, skin eruption in four, and uveitis in two. Rapidly progressive renal dysfunction occurred in four patients, and three of them underwent renal biopsy which revealed the findings of crescentic glomerulonephritis. Three patients were treated by prednisolone only, and two by the combination of prednisolone and cyclophosphamide. Renal function improved in two patients out of all. Idiopathic crescentic glomerulonephritis was diagnosed clinicopathol-ogically in three patients except for a patient of SLE and of malignant rheumatoid arthritis. These results suggest that serum p-ANCA evaluation may be useful in the diagnosis of patients with fever, inflammation, and renal dysfunction of unknown origin. If serum p-ANCA is positive, the application of renal biopsy for diagnosis should be attempted following appropriate treatments that might relieve symptoms and prevent renal failure