Kidney Res Clin Pract.  2015 Sep;34(3):180-184. 10.1016/j.krcp.2014.11.005.

Antineutrophil cytoplasmic antibody-negative pauci-immune glomerulonephritis with massive intestinal bleeding

• Kim M
• Kim YU
• Boo SJ
• Kim SM
• Kim HW

• KMID: 2381539
• DOI: http://doi.org/10.1016/j.krcp.2014.11.005

Abstract

A 61-year-old woman was admitted to hospital because of generalized edema and proteinuria. Her renal function deteriorated rapidly. Serum immunoglobulin and complement levels were within normal ranges. An autoantibody examination showed negative for antinuclear antibody and antineutrophil cytoplasmic antibody. Histologic examination of a renal biopsy specimen revealed that all of the glomeruli had severe crescent formations with no immune deposits. The patient was treated with steroid pulse therapy with cyclophosphamide followed by oral prednisolone. Fifteen days later, she experienced massive recurrent hematochezia. Angiography revealed an active contrast extravasation in a branch of the distal ileal artery. We selectively embolized with a permanent embolic agent. On the 45th hospital day, the patient suddenly lost consciousness. Brain computed tomography showed intracerebral hemorrhage. We report a case of antineutrophil cytoplasmic antibody-negative pauci-immune glomerulonephritis with massive intestinal bleeding and cerebral hemorrhage.

Keyword

Gastrointestinal hemorrhage; Glomerulonephritis; Vasculitis

MeSH Terms

Angiography
Antibodies, Antineutrophil Cytoplasmic
Antibodies, Antinuclear
Arteries
Biopsy
Brain
Cerebral Hemorrhage
Complement System Proteins
Consciousness
Cyclophosphamide
Cytoplasm*
Edema
Female
Gastrointestinal Hemorrhage
Glomerulonephritis*
Hemorrhage*
Humans
Immunoglobulins
Middle Aged
Prednisolone
Proteinuria
Reference Values
Vasculitis
Antibodies, Antineutrophil Cytoplasmic
Antibodies, Antinuclear
Complement System Proteins
Cyclophosphamide
Immunoglobulins
Prednisolone