A Case of Concurrent MPO-/PR3-Negative ANCA-Associated Glomerulonephritis and Membranous Glomerulopathy

Nakada, Yasuyuki; Tsuboi, Nobuyuki; Takahashi, Yasuhito; Yoshida, Hayato; Hara, Yoichiro; Okonogi, Hideo; Kawamura, Tetsuya; Arimura, Yoshihiro; Yokoo, Takashi

doi:10.1155/2015/316863

Cited by 3 publications

(5 citation statements)

References 15 publications

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“…Only a few of these autoantibodies, such as ANCAs, are currently used in routine practice in the diagnosis of patients with small-vessel vasculitis [ 8 ]. Moreover, in addition to MPO and PR3, other antigens can lead to the production of autoantibodies [ 19 ]. Based on this background, we aimed to test the total circulating ANCAs and we observed that patients with a SARS-CoV-2 infection had serum levels of ANCAs that were significantly higher than the control subjects.…”

Section: Discussionmentioning

confidence: 99%

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A Transient Increase in the Serum ANCAs in Patients with SARS-CoV-2 Infection: A Signal of Subclinical Vasculitis or an Epiphenomenon with No Clinical Manifestations? A Pilot Study

Gelzo

Cacciapuoti

Pinchera

et al. 2021

Viruses

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A relationship is emerging between SARS-CoV-2 infections and ANCA-associated vasculitis (AAV) because: (i) the pulmonary involvement of COVID-19 may mimic that observed in patients with AAV; (ii) the two diseases may occur together; (iii) COVID-19 may trigger AAV. However, few cases of AAV have been identified so far in COVID-19 patients. To define the frequency of ANCA autoimmunity in patients with SARS-CoV-2 infection, we analyzed the serum ANCAs and the serum PR3 and MPO antigens by immunoassays in 124 adult patients with a diagnosis of SARS-CoV-2 infection (16 were asymptomatic and 108 were hospitalized) and 48 control subjects. The serum ANCAs were significantly higher in the hospitalized patients compared with either the controls or the asymptomatic patients and increased with the progression of the COVID-19 severity. After one week of hospitalization, the values were significantly lower. In contrast, no differences emerged among the controls, asymptomatic and hospitalized patients for the PR3 and MPO serum levels. None of the patients had clinical signs of AAV with the exception of a severe pulmonary involvement. Further studies are necessary to define whether the increase in the serum ANCAs might mask subclinical vasculitis in a percentage of patients with SARS-CoV-2 infection or it is an epiphenomenon of SARS-CoV-2 infection with no clinical manifestations.

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Section: Discussionmentioning

confidence: 99%

“…Thus, the increase in the ANCAs in the patients of the second wave remains unexplained. This finding could be explained by the release of other antigens that can lead to ANCA production [ 19 ]. Furthermore, another explanation might be the formation of neutrophil extracellular traps in which neutrophils kill pathogens.…”

Section: Discussionmentioning

confidence: 99%

A Transient Increase in the Serum ANCAs in Patients with SARS-CoV-2 Infection: A Signal of Subclinical Vasculitis or an Epiphenomenon with No Clinical Manifestations? A Pilot Study

Gelzo

Cacciapuoti

Pinchera

et al. 2021

Viruses

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“…Se ha demostrado que la infusión de éstas no da lugar al desarrollo de glomerulonefritis en modelos animales. Con base en estos hallazgos, se ha propuesto que los ANCA no causan daño glomerular en forma directa, sino que los neutrófilos que ellos activan son los que producen los cambios histopatológicos ya descriptos mediante la liberación de agentes inflamatorios y proteínas de degradación, causantes del daño glomerular y la proliferación celular 5 .…”

Section: Discusión Y Conclusionesunclassified

“…Algunas investigaciones realizadas en Francia, Reino Unido, España y China se enfocaron en el estudio comparativo de dos grupos de pacientes: GNRP de tipo III positiva y negativa a ANCA. Dos de estos estudios, uno conducido en Pekín de Min Chen, et al 6 y otro realizado en España de Villacorta, et al 7 concluyeron que la población de pacientes con GNRP de tipo III negativa a ANCA es significativamente más joven al momento del diagnóstico, en comparación con la población de pacientes con GNRP de tipo III positiva a ANCA, tal y como se observó en el caso clínico presentado 5,6 .…”

Section: Discusión Y Conclusionesunclassified

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Glomerulonefritis de rápida progresión pauciinmunitaria negativa a ANCA en un paciente de 18 años: a propósito de un caso

Rivero¹,

Toledo²,

Díaz-Cuña³

et al. 2021

NEFRO

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La glomerulonefritis de rápida progresión (GNRP) pauciinmunitaria o de tipo III negativa a ANCA es infrecuente y representa tan sólo 10% a 20% del total de las GNRP pauciinmunitarias. Existen diferencias clínicas, analíticas y anatomopatológicas, entre las GNRP pauciinmunitarias negativas y positivas a ANCA. La sospecha de una GNRP pauciinmunitaria negativa a ANCA es elemental, ya que el pronóstico renal es tal vez peor en este subgrupo de pacientes. El tratamiento, al igual que en las GNRP de tipo III positivas a ANCA, se basa en la indicación de glucocorticoides y fármacos inmunosupresores.Palabras clave: Glomerulonefritis pauciinmunitaria. Glomerulonefritis de rápida progresión. Vasculitis negativa a anticuerpo anticitoplasma de neutrófilos (ANCA). Insuficiencia renal aguda. Síndrome nefrótico.

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Concomitant Histological Features of Membranous Nephropathy and Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis

Rajesh,

Mishra,

Roy

et al. 2024

IJN

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The simultaneous occurrence of vasculitic glomerulonephritis and membranous nephropathy is unusual. We report two cases that presented to our outpatient department with rapidly progressive renal failure. On evaluation, in one patient, anti-myeloperoxidase (MPO) titers were high, and renal biopsy was suggestive of concurrent necrotizing and diffuse crescentic anti-MPO anti-neutrophil cytoplasmic antigen-associated glomerulonephritis with the circumferential cellular crescent formation and membranous glomerulopathy. He responded to plasmapheresis followed by maintenance immunosuppression with oral cyclophosphomide. Another patient was treated with Methylprednisolone and two doses of rituximab. Both the patients showed marked symptomatic improvement and became dialysis independent with stable creatinine at 3 months.

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A Case of Concurrent MPO-/PR3-Negative ANCA-Associated Glomerulonephritis and Membranous Glomerulopathy

Cited by 3 publications

References 15 publications

A Transient Increase in the Serum ANCAs in Patients with SARS-CoV-2 Infection: A Signal of Subclinical Vasculitis or an Epiphenomenon with No Clinical Manifestations? A Pilot Study

A Transient Increase in the Serum ANCAs in Patients with SARS-CoV-2 Infection: A Signal of Subclinical Vasculitis or an Epiphenomenon with No Clinical Manifestations? A Pilot Study

Glomerulonefritis de rápida progresión pauciinmunitaria negativa a ANCA en un paciente de 18 años: a propósito de un caso

Concomitant Histological Features of Membranous Nephropathy and Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis

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