Lu Xiao, Yuan ChengYing, Li RongShan
Nephrology Division, The Affiliated People's Hospital of Shanxi Medical University, Taiyuan, China.
J Int Med Res. 2020 Dec;48(12):300060520977449. doi: 10.1177/0300060520977449.
Granulomatosis with polyangiitis (GPA) is a small-vessel vasculitis that is highly associated with anti-neutrophil cytoplasmic antibodies. GPA carries an increased risk of organ infarction, but renal infarction is rare. We herein describe a case of multiple renal infarctions caused by GPA. A 66-year-old man presented with hearing loss, nasal discharge, fatigue, and weight loss for several months. Cross-sectional contrast-enhanced computed tomography images revealed multiple low-attenuation areas in both kidneys. He subsequently developed fever and impaired renal function. Blood serum was positive for cytoplasmic anti-neutrophil cytoplasmic antibody and a renal biopsy showed granulomatous necrotizing vasculitis. He was diagnosed with GPA and treated with high-dose corticosteroids, plasma exchange, and cyclophosphamide. The patient ultimately entered clinical remission.
肉芽肿性多血管炎（GPA）是一种与抗中性粒细胞胞浆抗体高度相关的小血管炎。GPA会增加器官梗死的风险，但肾梗死很少见。我们在此描述一例由GPA引起的多发性肾梗死病例。一名66岁男性出现听力丧失、流涕、疲劳和体重减轻数月。横断面增强计算机断层扫描图像显示双肾有多个低密度区。随后他出现发热和肾功能损害。血清中胞浆抗中性粒细胞胞浆抗体呈阳性，肾活检显示肉芽肿性坏死性血管炎。他被诊断为GPA，并接受了大剂量皮质类固醇、血浆置换和环磷酰胺治疗。患者最终进入临床缓解期。
