Hydronephrosis as an unusual and distracting manifestation in the diagnosis of ANCA-positive vasculitis. About a case
Abstract
Obstructive nephropathy is considered an unusual presentation in ANCA-associated vasculitis. The following case describes a 38-year-old male with granulomatosis with polyangiitis and unilateral hydronephrosis, as well as a literature review. A 38-year-old male with an unremarkable medical background presents with a 3-week history of odynophagia, constitutional symptoms and anuric kidney injury. Initially managed as an obstructive nephropathy due to a left hydronephrosis finding, the patient eventually develops a diffuse alveolar hemorrhage, acute respiratory distress and perishes due to granulomatosis with polyangiitis. Obstructive nephropathy is an unusual manifestation of ANCA-associated vasculitis. Diagnostic suspicion is important in these multisystem pictures so as not to delay immunosuppressive treatment together with the rest of the required therapies.References
I. Kitching AR, Anders H-J, Basu N, Brouwer E, Gordon J, Jayne DR, et al. Anca-associated vasculitis. Nature Reviews Disease Primers 2020;6. doi:10.1038/s41572-020-0204-y.
II. Mejri R, Rhouma SB, Nouira Y. Bilateral staged ureteral stenosis secondary to wegener’s disease: a case report. Journal of Clinical Images and Medical Case Reports 2021;2. doi:10.52768/2766-7820/1454.
III. Lillaz J, Bernardini S, Algros M-P, Bittard H, Kleinclauss F. Wegener's granulomatosis: A rare cause of hydronephrosis. Case Reports in Medicine 2011;2011:1-3. doi:10.1155/2011/814794.
IV. Umemoto A, Ikeuchi H, Hiromura K, Hamatani H, Sakurai N, Sakairi T, et al. Hydronephrosis caused by a relapse of granulomatosis with polyangiitis (Wegener’s). Modern Rheumatology 2011;22:616-20. doi:10.1007/s10165-011-0554-0.
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