The Critical Role of Therapeutic Plasma Exchange in the Treatment of MPO-ANCA Associated Crescentic IgA Nephropathy

Authors

  • Deniz Durmaz Department of Internal Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
  • Buse Anbarcioglu Department of Internal Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
  • Mesudiye Bulut Department of Nephrology, Gulhane Training and Research Hospital, University of Health Sciences
  • Bulent Erdogan Department of Nephrology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
  • Ertugrul Celik Department of Pathology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
  • Hadim Akoglu Department of Nephrology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey

Abstract

Crescentic IgA nephropathy (IgAN) with the positivity for antineutrophilic cytoplasmic antibody (ANCA) is a novel and uncommon entity. The optimal management of this condition is not well-defined. We report a 49-years-old woman with complaints of skin rash and swelling of lower limbs. She had hematuria, proteinuria and, progressive renal impairment with positive myeloperoxidase (MPO)-ANCA test. A renal biopsy revealed MPO-ANCA-associated crescentic IgAN. Induction therapy was intravenous methylprednisolone, cyclophosphamide and, therapeutic plasma exchange (TPE). An unexpected disease flare-up was observed during induction immunosuppressive therapy which regressed after long-term TPE. The patient experienced a full renal recovery after treatment with long-term TPE, cyclophosphamide, and corticosteroids.

 

DOI: 10.52547/ijkd.6490

Author Biographies

  • Deniz Durmaz, Department of Internal Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
    Deniz Durmaz is a Medical Doctor of Internal Medicine in Gulhane Training and Research Hospital at University of Health Sciences 
  • Buse Anbarcioglu, Department of Internal Medicine, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
    Buse Anbarcioglu is a Medical Doctor of Internal Medicine in Gulhane Training and Research Hospital at University of Health Sciences
  • Mesudiye Bulut, Department of Nephrology, Gulhane Training and Research Hospital, University of Health Sciences
    Mesudiye Bulut is a Medical Doctor of Nephrology in Gulhane Training and Research Hospital at University of Health Sciences
  • Bulent Erdogan, Department of Nephrology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
    Bulent Erdogan is a Medical Doctor of Nephrology in Gulhane Training and Research Hospital at University of Health Sciences
  • Ertugrul Celik, Department of Pathology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
    Ertugrul Celik is a Medical Doctor of Pathology in Gulhane Training and Research Hospital at University of Health Sciences
  • Hadim Akoglu, Department of Nephrology, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
    Hadim Akoglu is a Professor of Nephrology in Gulhane Training and Research Hospital at University of Health Sciences

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Published

2022-03-06

Issue

Section

CASE REPORT | Kidney Diseases