Case reportSequential development of perinuclear ANCA-associated vasculitis and anti-glomerular basement membrane glomerulonephritis
Section snippets
Case report
A 75-year-old man was admitted to the department of nephrology in January 2003 for anuric acute renal failure. He was treated in the internal medicine department from March 2000, and a p-ANCA-associated vasculitis was diagnosed. He had no previous medical history. When first seen he was suffering from intense myalgias of the lower limbs and sensitivity of the calves, with weight loss and moderate fever. Clinical examination revealed mild livedo reticularis. Blood pressure was 140/90 mm Hg.
Discussion
We report the case of a 72-year-old man who sequentially developed a p-ANCA-associated vasculitis, followed 3 years later by Goodpasture syndrome, revealed by an acute renal failure. Plasma exchanges, high-dose steroids, and cyclophosphamide failed to improve renal function but induced the disappearance of p-ANCAs and anti-GBM antibodies.
During the first part of his medical history, our patient presented a p-ANCA-associated vasculitis that fulfilled the classification criteria for microscopic
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