Abstract
A 78 year old man presented with acute renal failure following a prolonged respiratory illness. A renal biopsy demonstrated severe suppurative interstitial nephritis with normal glomeruli. After nine weeks of antibiotics he remained anuric and a second biopsy demonstrated pauci-immune, necrotising glomerulonephritis. His subsequent clinical course was consistent with a diagnosis of Wegener's granulomatosis and antineutrophil cytoplasmic antibodies (ANCA) were detected. This is the first reported case of Wegener's granulomatosis presenting with an isolated tubulointerstitial lesion.
MeSH terms
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Acute Disease
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Aged
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Anti-Inflammatory Agents / therapeutic use
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Antibodies, Antineutrophil Cytoplasmic / immunology
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Antibodies, Antinuclear / immunology
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Biopsy
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Cyclophosphamide / therapeutic use
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Granulomatosis with Polyangiitis / complications*
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Granulomatosis with Polyangiitis / drug therapy
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Granulomatosis with Polyangiitis / pathology
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Humans
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Immunosuppressive Agents / therapeutic use
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Male
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Nephritis, Interstitial / drug therapy
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Nephritis, Interstitial / etiology*
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Nephritis, Interstitial / pathology
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Prednisone / therapeutic use
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Treatment Outcome
Substances
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Anti-Inflammatory Agents
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Antibodies, Antineutrophil Cytoplasmic
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Antibodies, Antinuclear
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Immunosuppressive Agents
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Cyclophosphamide
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Prednisone