Erschienen in:
18.08.2021 | Lesson for the Clinical Nephrologist
Granulomatosis with polyangiitis mimicking cancer: a diagnostic dilemma
Erschienen in: Journal of Nephrology | Ausgabe 2/2022
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A 56-year-old woman was admitted with a non-healing trophic lesion on a leg, and after admission, her kidney function deteriorated. Rapidly progressive glomerulonephritis (GN) was considered and anti proteinase-3 (antiPR3) Anti-Neutrophil Cytoplasmic Antibody (ANCA) positivity was found. The patient progressed to hemodialysis, with oliguria and macroscopic hematuria. Kidney biopsy confirmed pauci-immune crescentic glomerulonephritis with signs of peri-glomerular granulomatous inflammation (Fig. 1B). Furthermore, chest computed tomography (CT) scan revealed signs of alveolar hemorrhage. The skin defect on the patient’s lower limb was considered a vasculitis symptom as well. The patient was diagnosed with GPA (granulomatosis with polyangiitis).
Fig. 1
A Urinary bladder, vasculitis of the vein with fibrotic occlusion of the vessel lumen and segmental vasculitis with complete destruction of the vessel wall on the right side of the picture (arrows). B Glomerulus showing severe necrosis of the tuft surrounded by crescent formation, as well as fibrinoid necrosis of a hilar arteriole associated with prominent periglomerular granulomatous inflammation (Adapted from [1], with permission)
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