Granulomatosis with polyangiitis presenting as multiple renal masses: A case report with MRI findings

Yamamoto, Takahiro; Maruchi, Yuki; Asai, Ayumi; Takehara, Yumi; Koshikawa, Yu; Ikeda, Shuji; Kajikawa, Keishi; Banno, Shogo; Suzuki, Kôjiro

doi:10.1016/j.radcr.2023.01.001

Cited by 2 publications

(2 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, data were extracted from 41 articles, resulting in a total of 42 GPA patients presenting with renal masses: 23 (54.8%) were men and the median age was 45.3 (29.8–59.8) years [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Cutting-Edge Strategies for Renal Tumour-like Lesions in Granulomatosis with Polyangiitis: A Systematic Review

Iorio,

Pizzi,

Cecchin

et al. 2024

Diagnostics

View full text Add to dashboard Cite

Background: Granulomatosis with polyangiitis (GPA) is characterised by granulomatous inflammation and small-to-medium vessel necrotising vasculitis, mainly affecting respiratory tract and kidneys. Renal involvement presenting as tumour-like lesions poses diagnostic and treatment challenges. Methods: Following the observation of a GPA patient presenting with multiple renal tumour-like lesions, we conducted a systematic literature review on MEDLINE/PubMed, EMBASE, and Cochrane databases. Data gathered from the literature were analysed to summarise the diagnostic approach, management, and outcome of renal GPA-related tumour-like lesions. Results: a 49-year-old female presented with persistent constitutional symptoms and multiple bilateral renal lesions. Renal biopsy showed chronic interstitial inflammation with necrotising granulomas. Laboratory tests disclosed positive anti-proteinase 3 (PR3) anti-neutrophil cytoplasmic antibody (ANCA) leading to a final diagnosis of GPA. She was effectively treated with high-dose glucocorticoids and rituximab. Literature search yielded 41 articles, concerning 42 GPA patients with renal masses, presenting bilaterally in 23.8% of the cases. Positive PR3-ANCA was observed in 86.5% of the cases. Half of 42 patients showed kidney abnormalities. Treatment with glucocorticoids (83.3%) and immunosuppressive agents (80.9%) resulted in an overall good remission rate and favourable prognosis. Conclusions: GPA should be considered in the differential diagnoses of kidney tumour-like lesions. The diagnosis is challenging, and histological examination greatly contributes to the diagnostic work-up.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Regardless of the treatment regimen, an early diagnosis and timely initiation of immunosuppressive therapy can prevent disease progression and irreversible damage. Indeed, it is important to emphasise that the growth of these masses can be very rapid [ 25 , 35 ].…”

Section: Discussionmentioning

confidence: 99%