ABSTRACT
Anti-neutrophil cytoplasmic antibody ( ANCA)-associated glomerulonephritis is the most common cause of rapidly progressive glomerulonephritis worldwide , and the renal biopsy is not only the gold standard for establishing the diagnosis ,but also help-ful to judge the prognosis in clinical practice .In 2010,Berden et al presented a pathologic classification which proposed four general categories of lesions:Focal, crescentic, mixed, and sclerotic.And then, several validation studies proved the prognostic value of this classification.However, the difference of renal survival is large in various pathological types among different studies , so it needs more studies to develop its prognostic value .This review mainly focuses on clinical significance , definition of pathological feature , and vali-dation study about this classification .
ABSTRACT
Anti-neutrophil cytoplasmic antibody ( ANCA)-associated glomerulonephritis is the most common cause of rapidly progressive glomerulonephritis worldwide , and the renal biopsy is not only the gold standard for establishing the diagnosis ,but also help-ful to judge the prognosis in clinical practice .In 2010,Berden et al presented a pathologic classification which proposed four general categories of lesions:Focal, crescentic, mixed, and sclerotic.And then, several validation studies proved the prognostic value of this classification.However, the difference of renal survival is large in various pathological types among different studies , so it needs more studies to develop its prognostic value .This review mainly focuses on clinical significance , definition of pathological feature , and vali-dation study about this classification .
ABSTRACT
Glomerulonephritis (GN) is sometimes associated with infective endocarditis (IE). Bartonella endocarditis is difficult to diagnose because it is rare and cannot be detected by blood culture. This is the first report of cytoplasmic anti-neutrophil cytoplasmic antibody-positive subacute endocarditis-associated GN caused by Bartonella infection in South Korea. A 67-year-old man was hospitalized due to azotemia. He complained of weight loss and anorexia for 6 months. A diagnosis of IE was made based upon echocardiographic detection of vegetations on the mitral and aortic valves and a Bartonella antibody titer of 1:2,048. Renal histology identified focal crescentic GN. Azotemia and proteinuria improved after doxycycline and rifampin treatment combining with steroid therapy.
Subject(s)
Aged , Humans , Anorexia , Aortic Valve , Azotemia , Bartonella Infections , Bartonella , Cytoplasm , Diagnosis , Doxycycline , Echocardiography , Endocarditis , Glomerulonephritis , Korea , Proteinuria , Rifampin , Weight LossABSTRACT
Glomerulonephritis (GN) is sometimes associated with infective endocarditis (IE). Bartonella endocarditis is difficult to diagnose because it is rare and cannot be detected by blood culture. This is the first report of cytoplasmic anti-neutrophil cytoplasmic antibody-positive subacute endocarditis-associated GN caused by Bartonella infection in South Korea. A 67-year-old man was hospitalized due to azotemia. He complained of weight loss and anorexia for 6 months. A diagnosis of IE was made based upon echocardiographic detection of vegetations on the mitral and aortic valves and a Bartonella antibody titer of 1:2,048. Renal histology identified focal crescentic GN. Azotemia and proteinuria improved after doxycycline and rifampin treatment combining with steroid therapy.
Subject(s)
Aged , Humans , Anorexia , Aortic Valve , Azotemia , Bartonella Infections , Bartonella , Cytoplasm , Diagnosis , Doxycycline , Echocardiography , Endocarditis , Glomerulonephritis , Korea , Proteinuria , Rifampin , Weight LossABSTRACT
Objective To investigate the relationship of the serum anti-lysosome associated membrane protein 2 (LAMP-2) antibody levels and anti-neutrophil cytoplasmic antibodies (ANCA)-associated glomerulonephritis.Methods Thirty-three patients with new onset ANCA-associated glomerulonephritis and thirty healthy controls were enrolled.ANCA detection was performed using indirect immunofluorescence (IIF).Enzyme-linked immunosorbent assay (ELISA) was used to detect myeloperoxidase (MPO),proteinase-3 (PR3) and other ANCA-associated antibodies including LAMP-2.The cut-off value of the serum anti-LAMP-2 antibody was determined by a receiver operating characteristic (ROC) curve.Results The serum levels of anti-LAMP-2 antibody in new onset ANCA-associated glomerulonephritis patients were significantly higher than remission stage ANCA-associated glomerulonephritis patients and healthy controls (P < 0.05).The serum levels of anti-LAMP-2 antibody showed no visible difference between the remission ANCA-associated glomerulonephritis patients and healthy controls (P > 0.05).The levels of anti-LAMP-2 antibody showed a strong positive correlation with ESR,Scr,BUN,proteinuria,crescent proportion and Birmingham vasculitis activity score (BVAS) and a negative correlation with Ccr,Hb and Alb.Conclusions Anti-LAMP-2 antibody is correlated with the activity of ANCA-associated glomerulonephritis and the severity of renal damage.It may be a useful indicator on the activity of ANCA-associated glomerulonephritis.