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AP-VAS 2012 case report: a case of ANCA-negative crescentic glomerulonephritis complicating multiple opportunistic

Shinya Yamamoto1, Tetsuya Makiishi2, Yuko Sogabe3

  • 1Department of Internal Medicine, Division of Nephrology, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-Ku, Osaka, 530-8480, Japan. shinya0930@gmail.com.

CEN Case Reports
|May 17, 2017
PubMed

Insights

ANCA-negative crescentic glomerulonephritis (GN) may present differently than ANCA-positive GN. This case highlights rare gastrointestinal opportunistic infections during immunosuppressive therapy in ANCA-negative GN.

Area of Science:

  • Nephrology
  • Immunology
  • Infectious Diseases

Background:

  • Crescentic glomerulonephritis (GN) is a major cause of rapidly progressive GN.
  • Pauci-immune crescentic GN is typically ANCA-associated, but ANCA-negative cases exist, comprising 10-30% of patients.
  • ANCA-negative pauci-immune crescentic GN may represent a distinct clinical entity.

Purpose of the Study:

  • To report a case of ANCA-negative crescentic GN.
  • To describe the occurrence of multiple digestive tract opportunistic infections during immunosuppressive therapy.
  • To emphasize the rarity of such localized infections in this context.

Main Methods:

  • Case report of a patient with ANCA-negative crescentic GN.
  • Documentation of opportunistic infections including Candida albicans, herpes simplex virus, and Cytomegalovirus.
  • Administration of antifungal (itraconazole) and antiviral (valaciclovir, ganciclovir) therapies.

Main Results:

  • The patient presented with ANCA-negative crescentic GN.
  • Multiple opportunistic infections were diagnosed in the digestive tract during immunosuppressive treatment.
  • Successful recovery was achieved following targeted antifungal and antiviral interventions.

Conclusions:

  • ANCA-negative crescentic GN may have unique clinical characteristics.
  • Elderly patients undergoing immunosuppression are susceptible to opportunistic infections.
  • Multiple, localized gastrointestinal opportunistic infections are a rare complication in ANCA-negative crescentic GN.

Keywords:
ANCA-negativeCandida albicansColitisCrescentic glomerulonephritisCytomegalovirusEsophagitisHerpes simplex virusOpportunistic infection

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