A Patient with MPO-ANCA-positive IgA Nephropathy Diagnosed with the Clinical Onset of Macrohematuria

Yasukawa, Minoru; Kitagawa, Shinya; Togashi, Ryo; Asakawa, Shinichiro; Nagura, Michito; Arai, Shigeyuki; Tamura, Yoshifuru; Kondo, Fukuo; Ohashi, Ryuji; Uchida, Shunya; Shibata, Shigeru; Fujigaki, Yoshihide

doi:10.2169/internalmedicine.2475-18

Cited by 4 publications

(1 citation statement)

References 18 publications

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“…There are great differences in clinical manifestations and prognoses between IgAN and AAV, and the coexistence of IgAN and ANCA positivity was very uncommon. There are only case reports [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] and 2 small case control studies [20,21] that reported some of the features of IgAN patients with ANCA positivity. This study explored the clinicopathological and prognostic features of IgAN patients with ANCA positivity in a large consecutive cohort with long time follow-up.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological Features and Outcomes of IgA Nephropathy with Serum Antineutrophil Cytoplasmic Autoantibody Positivity

Li,

Chen,

Chen

et al. 2023

Am J Nephrol

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Objective: IgA nephropathy (IgAN) with serum Antineutrophil Cytoplasmic Autoantibody (ANCA) positivity is uncommon. This study analyzed the clinicopathologic features and prognosis of IgAN patients with serum ANCA positivity. Methods: 2864 IgAN patients were tested for ANCA by the indirect immunofluorescence assay and chemiluminescence immunoassay. Patients with serum ANCA positivity (n=85) were identified and their clinical, pathological and prognostic characteristics were analyzed. They were compared with ANCA negative IgAN patients (n=170) and ANCA-associated systemic vasculitis (AAV) with renal involvement patients (n=85) selected randomly. Result：2.97% (85/2864) of IgAN were ANCA positive and 4 patients were diagnosed as crescentic IgAN with ANCA positivity. The clinicopathological characteristics of ANCA-positive IgAN patients were comparable to ANCA-negative IgAN patients, but they had higher antinuclear antibodies (ANA) positive rates and lower levels of renal interstitial inflammation and less immune depositions than ANCA-negative IgAN patients. Compared with AAV patients, ANCA-positive IgAN patients were younger, fewer extrarenal manifestations, milder renal damage and more immune complexes depositions. The renal outcomes were similar between IgAN patients with and without ANCA positivity. Multivariate Cox analysis revealed that in IgAN patients with ANCA positivity, male, ANA positivity, higher serum creatinine and proteinuria, and more severe renal tubular atrophy/interstitial fibrosis were risk factors for adverse renal outcomes. Conclusion: The clinical, pathological features and prognosis of ANCA-positive IgAN patients were similar with ANCA-negative IgAN patients except for higher ANA positive rate, milder renal inflammation and less immune depositions. ANA positivity was an independent risk factor for adverse renal outcomes in ANCA-positive IgAN patients.

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Section: Introductionmentioning

confidence: 99%

Clinicopathological Features and Outcomes of IgA Nephropathy with Serum Antineutrophil Cytoplasmic Autoantibody Positivity

Li,

Chen,

Chen

et al. 2023

Am J Nephrol

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ANCA-associated vasculitis flare might be provoked by COVID-19 infection: a case report and a review of the literature

Özcan

Sönmez

Karaca

et al. 2022

Clinical Kidney Journal

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Mesangial IgA deposition is the hallmark of IgA nephropathy. In some cases, crescentic involvement which might be associated with systemic leukocytoclastic vasculitis is documented; in such cases, the disease is called Henoch-Schonlein purpura (IgA vasculitis). Even more rarely, the coexistence of IgA nephropathy and ANCA seropositivity was reported. IgA nephropathy might be complicated by acute kidney injury due to different causes. Herein, we present a patient with mesangial IgA deposition and ANCA seropositivity, who developed acute kidney injury, hematuria, and hemoptysis during the course of COVID-19 disease and was diagnosed with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis based on clinical, laboratory, and radiological findings. The patient was treated successfully with immunosuppressive therapy. We also made a systematic review of the literature to reveal and present the cases with COVID-19 and ANCA-associated vasculitis.

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The glomerular crescent

Anguiano

Kain

Anders

2020

Current Opinion in Nephrology and Hypertension

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A Patient with MPO-ANCA-positive IgA Nephropathy Diagnosed with the Clinical Onset of Macrohematuria

Cited by 4 publications

References 18 publications

Clinicopathological Features and Outcomes of IgA Nephropathy with Serum Antineutrophil Cytoplasmic Autoantibody Positivity

Clinicopathological Features and Outcomes of IgA Nephropathy with Serum Antineutrophil Cytoplasmic Autoantibody Positivity

ANCA-associated vasculitis flare might be provoked by COVID-19 infection: a case report and a review of the literature

The glomerular crescent

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