Granulomatosis with Polyangiitis (GPA) Case Report Outlining the Importance of Urinalysis in Patients Presenting with Pulmonary Cavitary Lesions

Abstract

Zagelbaum N (2016) Granulomatosis with polyangiitis (GPA) case report outlining the importance of urinalysis in patients presenting with pulmonary cavitary lesions

Granulomatosis With Polyangiitis: Cardiac, Renal, and Respiratory Involvement

“…Glomerulonephritis is the most common renal pathology affecting 70-85% of people with GPA but only 10-15% of patients present with severe renal inadequacy with creatinine over 2 mg/dL [ 6 ]. Though over 70% of patients can present with renal symptoms, usually this takes over two years to develop [ 7 ]. Our patient’s disease rapidly progressed, and he had a need for dialysis within days of diagnosis.…”

Diagnostic dilemma of Wegener’s granulomatosis and its effective management: A rare case report and update

“…12,13 As per previous reports, later on we decided to add plasmapheresis with existing regimen to quickly decrease the load of pathogenic ANCA. 9,14,15 As on date, no much clinical data and large multi-modal trials are present to support the treatment. However, some studies suggested that utilisation of this plasmapheresis in severe renal failure scenarios have showed a reduction of dialysis from 60% to 40% post 1 year followed by treatment.…”

“…However, some studies suggested that utilisation of this plasmapheresis in severe renal failure scenarios have showed a reduction of dialysis from 60% to 40% post 1 year followed by treatment. 14,16 To keep symptoms under control and to avoid relapse, rituximab was introduced to the existing pulse steroids regimen. Rituximab (2 doses) has showed some positive results by clearing the circulating B cells from the circulation and by targeting the CD20 antigen on B cells, without affecting plasma cells which may be important in disease relapse.…”

“…Rituximab (2 doses) has showed some positive results by clearing the circulating B cells from the circulation and by targeting the CD20 antigen on B cells, without affecting plasma cells which may be important in disease relapse. 14,17 Another 5 doses were of rituximab were given and patient symptoms improved dramatically. Patient was discharged once stabilised and saturation reached normal at room air.…”