J Korean Rheum Assoc.  2000 Mar;7(1):83-89.

A Case of P-ANCA Positive Necrotizing Glomerulonephritis with Eosinophilia

• Shin JY
• Kang EW
• Ryu DR
• Song JS
• Lee WK
• Park YB
• Kim L
• Jung HJ
• Lee SK

Abstract

Antineutrophil cytoplasmic antibodies (ANCAs) are now regarded as a serologic marker for pauci-immune crescentic necrotizing glomerulonephritis either in renal-limited form or in association with systemic vasculitis, such as Wegener? granulomatosis, microscopic polyarteritis, and Churg-Strauss syndrome. Two major ANCA antigens have been indentified: proteinase3, which produces a cytoplasmic staining pattern termed C-ANCA, and myeloperoxidase, which produces a perinuclear pattern termed P-ANCA on ethanol-fixed neutrophils by indirect immunofluorescence. In ANCA- associated diseases, eosinphilia in excess of 1.5X109/L has been proposed to be characteristic of Churg-Strauss syndrome and is rare in other forms of ANCA-associated systemic vasculitis and crescentic necrotizing glomerulonephritis. Recently, there were two cases of P-ANCA positive crescentic necrotizing glomerulonephritis with peripheral blood eosinophilia and extrarenal microscopic vasculitis without asthma or granulomas. We experienced a patient with P-ANCA positive pauci-immune necrotizing glomerulonephritis with few eosinophilic infiltration and eosinophilia. He improved with oral prednisolone along with combination of intravenous cyclophosphamide. So we report this case with the review of literature.

Keyword

ANCA; Pauci-immune crescentic necrotizing glomerulonephritis; Eosinophilia

MeSH Terms

Antibodies, Antineutrophil Cytoplasmic*
Asthma
Churg-Strauss Syndrome
Cyclophosphamide
Cytoplasm
Eosinophilia*
Eosinophils
Fluorescent Antibody Technique, Indirect
Glomerulonephritis*
Granuloma
Humans
Neutrophils
Peroxidase
Prednisolone
Systemic Vasculitis
Vasculitis
Antibodies, Antineutrophil Cytoplasmic
Cyclophosphamide
Peroxidase
Prednisolone