caa a22 4500 445883030 CHVBK 20180317145550.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s10157-011-0407-3 doi (NATIONALLICENCE)springer-10.1007/s10157-011-0407-3 A Japanese case of proteinase 3 antineutrophil cytoplasmic autoantibody-associated pauci-immune-type crescentic glomerulonephritis without valvular endocarditis [Elektronische Daten] [Satoshi Morimoto, Fumitaka Nakajima, Tatsuyori Morita, Kazunori Someya, Makiko Kusabe, Mitsutaka Nakahigashi, Takatomi Yurugi, Masayoshi Fukui, Takayuki Okamoto, Fusakazu Jo, Nagaoki Toyoda, Toshiji Iwasaka] A 74-year-old male without recent medical treatment visited our hospital complaining of fever and lack of appetite. Upon examination severe azotemia, proteinuria, and urinary occult blood were noted, and the patient was admitted. Results of a blood test showed that his proteinase 3 antineutrophil cytoplasmic autoantibody (PR3-ANCA) level was high. A transthoracic echocardiogram indicated normal cardiac function and no valvular regurgitation or stenosis. Necrotizing glomerulonephritis accompanied by cellular crescentic bodies, but not granuloma, was noted on renal biopsy. An immunofluorescence study demonstrated no immunofluorescence staining in the glomerulus or in the tubulointerstitial or vascular compartments. No lesion was present in the lung or upper respiratory tract. The patient was diagnosed with PR3-ANCA-associated pauci-immune-type crescentic glomerulonephritis and treated with steroids. This treatment resulted in rapid normalization of C-reactive protein, and the PR3-ANCA level slowly decreased and converted to negative. The renal function, however, did not improve, and maintenance dialysis was introduced. No pulmonary or upper airway lesion has developed during 18months of follow-up. PR3-ANCA-positive crescentic glomerulonephritis accompanied by valvular endocarditis has been described by several reports in Japan; however, this case was not complicated by valvular endocarditis. To our knowledge, this is the 4th case report describing PR3-ANCA-associated crescentic glomerulonephritis in Japan. Japanese Society of Nephrology, 2011 Vasculitis nationallicence Wegener's granulomatosis nationallicence MPO-ANCA nationallicence Steroid nationallicence Renal biopsy nationallicence Morimoto Satoshi Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut Nakajima Fumitaka Department of Nephrology, Moriguchi Keijinkai Hospital, 570-0021, Moriguchi, Osaka, Japan aut Morita Tatsuyori Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut Someya Kazunori Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut Kusabe Makiko Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut Nakahigashi Mitsutaka Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut Yurugi Takatomi Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut Fukui Masayoshi Department of Nephrology, Moriguchi Keijinkai Hospital, 570-0021, Moriguchi, Osaka, Japan aut Okamoto Takayuki Department of Nephrology, Moriguchi Keijinkai Hospital, 570-0021, Moriguchi, Osaka, Japan aut Jo Fusakazu Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut Toyoda Nagaoki Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut Iwasaka Toshiji Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut Clinical and Experimental Nephrology Springer Japan 15/3(2011-06-01), 419-423 1342-1751 15:3<419 2011 15 10157 https://doi.org/10.1007/s10157-011-0407-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0407-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Morimoto Satoshi Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut NATIONALLICENCE 700 1- Nakajima Fumitaka Department of Nephrology, Moriguchi Keijinkai Hospital, 570-0021, Moriguchi, Osaka, Japan aut NATIONALLICENCE 700 1- Morita Tatsuyori Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut NATIONALLICENCE 700 1- Someya Kazunori Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut NATIONALLICENCE 700 1- Kusabe Makiko Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut NATIONALLICENCE 700 1- Nakahigashi Mitsutaka Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut NATIONALLICENCE 700 1- Yurugi Takatomi Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut NATIONALLICENCE 700 1- Fukui Masayoshi Department of Nephrology, Moriguchi Keijinkai Hospital, 570-0021, Moriguchi, Osaka, Japan aut NATIONALLICENCE 700 1- Okamoto Takayuki Department of Nephrology, Moriguchi Keijinkai Hospital, 570-0021, Moriguchi, Osaka, Japan aut NATIONALLICENCE 700 1- Jo Fusakazu Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut NATIONALLICENCE 700 1- Toyoda Nagaoki Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut NATIONALLICENCE 700 1- Iwasaka Toshiji Second Department of Internal Medicine, Kansai Medical University, 2-3-1, Shin-machi, 573-1191, Hirakata, Osaka, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/3(2011-06-01), 419-423 1342-1751 15:3<419 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer