A case report of granulomatous polyangiitis complicated by tuberculous lymphadenitis

Abstract

Rational:Granulomatous polyangiitis (GPA) is a type of vasculitis involving medium and small arteries, typically affecting the upper and lower respiratory tract with coexisting glomerulonephritis. GPA is also characterized by necrotizing granulomatous inflammation and the presence of antineutrophil cytoplasm antibodies (ANCA). So far, various infections have lead to elevation of titers of serum ANCA, making it difficult to diagnose.Patient Concerns:We report a 50-year-old woman who was diagnosed as tuberculous lymphadenitis. During the treatment by anti-tuberculosis (TB) drugs, rapidly progressive renal failure and pleurisy had appeared with elevated titer of PR3-ANCA. Renal biopsy revealed crescentic glomerulonephritis.Diagnosis:Renal biopsy revealed crescentic glomerulonephritis and diagnosis of GPA was made.Interventions:Steroid therapy had been started with continuation of anti-TB drugs.Outcomes:Renal dysfunction had gradually recovered and pleurisy had disappeared with decreasing titer of PR3-ANCA.Lessons:This is the first report of GPA complicated by TB infection. When we encounter a case with rapidly progressive renal failure during the TB infection, complication of GPA should be suspected as 1 of the different diagnosis.

Diagnostic dilemma of Wegener’s granulomatosis and its effective management: A rare case report and update

“…1 It is a uncommon, multi-systemic, life threatening autoimmune inflammatory condition characterized by necrotizing granulomatous inflammation and Antineutrophil Cytoplasm Antibodies (ANCA). 2 Its systematic vasculitides involves various organs such as the sinuses, upper respiratory tract, the lungs, and the kidneys. 3 The prevalence of GPA ranges from 2.5 to 146 cases/per million, with an incidence of 0.5 to ~12 cases/per million person-years.…”

Main tract stenosis complicated by granulomatous with polyangiitis: A case report

“…The incidence of GPA is ~1/100,000 in the United Kingdom, Germany and Norway, where GPA usually occur in older people, but are relatively rare in children and young people (2). Although GPA mainly affects the upper and lower respiratory tract, kidneys and eyes, neurological manifestations and infectious diseases have been previously associated with GPA (3)(4)(5).…”