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IgA nephropathy in patients with serum anti-neutrophil cytoplasmic autoantibody (ANCA) positivity: case series
- Source :
- Brazilian Journal of Nephrology, Issue: ahead, Published: 21 JUL 2021, Brazilian Journal of Nephrology v.44 n.1 2022, Jornal Brasileiro de Nefrologia, Sociedade Brasileira de Nefrologia (SBN), instacron:SBN, Brazilian Journal of Nephrology, Brazilian Journal of Nephrology n.ahead 2021
- Publication Year :
- 2022
- Publisher :
- FapUNIFESP (SciELO), 2022.
-
Abstract
- Some cases of patients with IgA nephropathy diagnosed via kidney biopsy and antineutrophil cytoplasmic antibody (ANCA) positivity have been reported. This article describes a case series comprising patients with IgA nephropathy and ANCA positivity seen at a medical center in the city of São Paulo, Brazil, from 1996 to 2016. A total of 111 patients underwent diagnostic kidney biopsies for IgA nephropathy. Five were ANCA-positive at the time of diagnosis; their mean age was 45 ± 15.3 years and they were predominantly females with a mean proteinuria of 2.2 ± 0.9 g/day and a median serum creatinine level of 2.5 (2.0 - 8,6) mg/dL; all had hematuria. Four of the five were cANCA-positive (80%); all had normal serum C3 and C4 levels; and 80% were positive for ANA. One case presented an association with infection, but no associations were found with medication. One patient had granuloma and another had a collapsing lesion. This article describes the cases of five ANCA-positive patients (with predominantly cANCA positivity) submitted to diagnostic kidney biopsies for IgA nephropathy; one patient had a collapsing lesion, but progressed well. Resumo Alguns casos clínicos de biópsia renal diagnóstica de nefropatia por IgA em pacientes com títulos séricos positivos de anticorpo anticitoplasma de neutrófilos (ANCA) vêm sendo publicados. Descreve-se uma série de casos de nefropatia por IgA com ANCA positivo de centro único da cidade de São Paulo, Brasil, no período de 1996 a 2016. No período estudado, houve 111 pacientes com biópsia renal com diagnóstico de nefropatia por IgA; destes, 5 tinham ANCA positivo ao diagnóstico com média de idade de 45 ± 15,3 anos, predominando o sexo feminino, com média de proteinúria de 2,2 ± 0,9 g/dia, hematúria presente em 100% dos casos e mediana de creatinina sérica de 2,5 (2,0 - 8,6) mg/dL. O cANCA foi o padrão mais encontrado, em 4 dos 5 casos (80%), com os níveis séricos das frações de complemento C3 e C4 normais em todos e FAN positivo em 80% dos casos. Houve associação com infecções em um caso, mas sem associação com medicações. À microscopia óptica, um dos pacientes tinha granuloma e outro, lesão colapsante. Em resumo, descreve-se cinco casos de pacientes com biopsia renal diagnóstica de nefropatia por IgA com ANCA sérico positivo predominando cANCA, destacando um paciente desse grupo com microscopia óptica com lesão colapsante que, apesar disso, teve boa evolução.
- Subjects :
- Adult
Male
medicine.medical_specialty
Biopsy
030232 urology & nephrology
Gastroenterology
Antibodies, Antineutrophil Cytoplasmic
Nephropathy
Lesion
Anticorpos Anticitoplasma de Neutrófilos
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
Glomerulonefrite por IGA
Anti-neutrophil cytoplasmic antibody
030203 arthritis & rheumatology
Kidney
Proteinuria
medicine.diagnostic_test
business.industry
Autoantibody
Glomerulonephritis, IGA
General Medicine
Middle Aged
medicine.disease
Diseases of the genitourinary system. Urology
Biópsia
medicine.anatomical_structure
Granuloma
Female
RC870-923
medicine.symptom
business
Brazil
Subjects
Details
- ISSN :
- 21758239 and 01012800
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- Brazilian Journal of Nephrology
- Accession number :
- edsair.doi.dedup.....085b949f96d520f25ca650fa082424bc