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http://dx.doi.org/10.3339/ckd.22.031

Two pediatric cases with hematuria, normal renal function and positive antineutrophil cytoplasmic antibodies  

Ji Hyeon Lim (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine)
Ji Won Jung (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine)
Heoun Jeong Go (Department of Pathology, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine)
Joo Hoon Lee (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine)
Young Seo Park (Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine)
Publication Information
Childhood Kidney Diseases / v.26, no.2, 2022 , pp. 86-90 More about this Journal
Abstract
Antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis requires prompt diagnosis and treatment, since renal function at the time of diagnosis is significantly associated with renal outcomes. Here, we report two pediatric patients with ANCA-positive glomerulonephritis initially presenting with hematuria, mild proteinuria, and normal renal function. The first patient with a high myeloperoxidase-ANCA titer (>134 IU/mL) was diagnosed with rapidly progressive glomerulonephritis based on renal biopsy and treated with immunosuppressive therapy after 10 months of follow-up. The second patient with a low myeloperoxidase-ANCA titer (11 IU/mL) maintained normal kidney function without medication. Two cases showed different clinical course according to ANCA titer.
Keywords
Antineutrophil cytoplasmic antibody; Case reports; Glomerulonephritis; Vasculitis;
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Times Cited By KSCI : 1  (Citation Analysis)
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1 Jennette JC. Rapidly progressive crescentic glomerulonephritis. Kidney Int 2003;63:1164-77.   DOI
2 Hauer HA, Bajema IM, Van Houwelingen HC, Ferrario F, Noel LH, Waldherr R, et al. Determinants of outcome in ANCA-associated glomerulonephritis: a prospective clinico-histopathological analysis of 96 patients. Kidney Int 2002;62:1732-42.   DOI
3 Vergunst CE, van Gurp E, Hagen EC, van Houwelingen HC, Hauer HA, Noel LH, et al. An index for renal outcome in ANCA-associated glomerulonephritis. Am J Kidney Dis 2003;41:532-8.   DOI
4 Booth AD, Almond MK, Burns A, Ellis P, Gaskin G, Neild GH, et al. Outcome of ANCA-associated renal vasculitis: a 5-year retrospective study. Am J Kidney Dis 2003;41:776-84.   DOI
5 Fussner LA, Hummel AM, Schroeder DR, Silva F, Cartin-Ceba R, Snyder MR, et al. Factors determining the clinical utility of serial measurements of antineutrophil cytoplasmic antibodies targeting proteinase 3. Arthritis Rheumatol 2016;68:1700-10.   DOI
6 Cohen RA, Brown RS. Microscopic hematuria. N Engl J Med 2003;348:2330-8.   DOI
7 Guchelaar NAD, Waling MM, Adhin AA, van Daele PLA, Schreurs MWJ, Rombach SM. The value of anti-neutrophil cytoplasmic antibodies (ANCA) testing for the diagnosis of ANCA-associated vasculitis, a systematic review and meta-analysis. Autoimmun Rev 2021;20:102716.
8 Gaffo AL. Diagnostic approach to ANCA-associated vasculitides. Rheum Dis Clin North Am 2010;36:491-506.   DOI
9 Hagen EC, Daha MR, Hermans J, Andrassy K, Csernok E, Gaskin G, et al. Diagnostic value of standardized assays for anti-neutrophil cytoplasmic antibodies in idiopathic systemic vasculitis. Kidney Int 1998;53:743-53.
10 HoubenE,BaxWA, vanDamB,SliekerWAT,VerhaveG, FrerichsFCP, et al. Diagnosing ANCA-associated vasculitis in ANCA positive patients: a retrospective analysis on the role of clinical symptoms and the ANCA titre. Medicine (Baltimore) 2016;95:e5096.
11 Kerr GS, Fleisher TA, Hallahan CW, Leavitt RY, Fauci AS, Hoffman GS. Limited prognostic value of changes in antineutrophil cytoplasmic antibody titer in patients with Wegener's granulomatosis. Arthritis Rheum 1993;36:365-71.   DOI
12 Baskin E, Bakkaloglu A, Besbas N, Hascelik G, Saatci U, Gok F, et al. Ceruloplasmin levels in antineutrophil cytoplasmic antibody-positive patients. Pediatr Nephrol 2002;17:917-9.   DOI
13 Smith RM, Jones RB, Jayne DR. Progress in treatment of ANCA-associated vasculitis. Arthritis Res Ther 2012;14:210.
14 Jennette JC, Nachman PH. ANCA glomerulonephritis and vasculitis. Clin J Am Soc Nephrol 2017;12:1680-91.   DOI
15 Jayne DR, Gaskin G, Rasmussen N, Abramowicz D, Ferrario F, Guillevin L, et al. Randomized trial of plasma exchange or high-dosage methylprednisolone as adjunctive therapy for severe renal vasculitis. J Am Soc Nephrol 2007;18:2180-8.   DOI