Eosinophilic granulomatosis with polyangiitis complicated with rapidly progressive glomerulonephritis in a young man who is a healthy cyclist.
| Title: | Eosinophilic granulomatosis with polyangiitis complicated with rapidly progressive glomerulonephritis in a young man who is a healthy cyclist. |
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| Authors: | Micarelli D; Nephrology and Dialysis Unit, San Giovanni Evangelista Hospital, Tivoli, Italy.; Duca I; Rheumatology Consultant, ASL Roma 5, Tivoli, Italy.; Tartaglione L; Nephrology and Dialysis Unit, San Giovanni Evangelista Hospital, Tivoli, Italy.; Frassetti N; Nephrology and Dialysis Unit, San Giovanni Evangelista Hospital, Tivoli, Italy.; Coppola B; Nephrology and Dialysis Unit, San Giovanni Evangelista Hospital, Tivoli, Italy.; Polistena F; Nephrology and Dialysis Unit, San Giovanni Evangelista Hospital, Tivoli, Italy.; Iannacci GR; Nephrology and Dialysis Unit, San Giovanni Evangelista Hospital, Tivoli, Italy.; Comegna C; Nephrology and Dialysis Unit, San Giovanni Evangelista Hospital, Tivoli, Italy.; Addesse R; Nephrology and Dialysis Unit, San Giovanni Evangelista Hospital, Tivoli, Italy.; Polito P; Nephrology and Dialysis Unit, San Giovanni Evangelista Hospital, Tivoli, Italy. |
| Source: | Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia [G Ital Nefrol] 2022 Apr 21; Vol. 39 (2). Date of Electronic Publication: 2022 Apr 21. |
| Publication Type: | Case Reports; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Società Italiana di Nefrologia Country of Publication: Italy NLM ID: 9426434 Publication Model: Electronic Cited Medium: Internet ISSN: 1724-5990 (Electronic) Linking ISSN: 03935590 NLM ISO Abbreviation: G Ital Nefrol Subsets: MEDLINE |
| Imprint Name(s): | Publication: : Rome : Società Italiana di Nefrologia.; Original Publication: Milano : Wichtig editore |
| MeSH Terms: | Churg-Strauss Syndrome*/complications ; Churg-Strauss Syndrome*/diagnosis ; Churg-Strauss Syndrome*/drug therapy ; Glomerulonephritis*/complications ; Glomerulonephritis*/drug therapy ; Granulomatosis with Polyangiitis*/complications; Cyclophosphamide/therapeutic use ; Inflammation/complications ; Antibodies, Antineutrophil Cytoplasmic ; Female ; Humans ; Male ; Middle Aged |
| Abstract: | Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare systemic vasculitis. Rapidly progressive glomerulonephritis (RPGN) is a rare complication of EGPA. We report a case of a 60-year-old man, who is also a skilled cyclist, who was hospitalized to investigate a symptomatology that had arisen over the previous months and worsened in the last few weeks, to the point of limiting normal everyday activities. The physical examination revealed the presence of livedo reticularis of the four limbs, purpura of the lower limbs, arthritis of the ankles, and low-grade fever; the patient showed intense asthenia, loss of appetite, retrosternal heartburn, and a scarcely pharmacologically controlled asthma. He also reported weight loss (about 5 kg in the last 6 months). Rapidly progressing renal failure was observed with hyper-eosinophilia (4.7 thousand/μL eosinophils, 44% of total leukocytes), pulmonary opacities on chest computed tomography (CT), and sinusitis on CT of the facial massif. The search for antibodies directed against neutrophil cytoplasm (ANCA) revealed a high level of pANCA (pANCA ++, ELISA anti-MPO 666 UI/ml), associated with an increment of inflammation indicators. The induction therapy was high-dosage intravenous glucorticoids and cyclophosphamide, to improve the short and long-term prognosis. After 7 months of treatment, the patient reported a considerable improvement of the symptoms, which at that point did not necessitate pharmacological interventions. The eosinophils value was 0 cells/mm³, the inflammation indexes were back to the norm, and the renal function appeared significantly improved.; (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.) |
| Contributed Indexing: | Keywords: eosinophilic granulomatosis with polyangiitis; ANCA-associated vasculitis; Churg-Strauss Syndrome; rapidly progressive glomerulonephritis |
| Substance Nomenclature: | 0 (Antibodies, Antineutrophil Cytoplasmic); 8N3DW7272P (Cyclophosphamide) |
| Entry Date(s): | Date Created: 20220426 Date Completed: 20220428 Latest Revision: 20220428 |
| Update Code: | 20260130 |
| PMID: | 35471001 |
| Database: | MEDLINE |
Case Reports; Journal Article