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Interpretation of Serologic Testing in Glomerular Diseases

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Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation

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Abstract

A 69-year-old Caucasian male was admitted to the hospital with progressive dyspnea, decreased urine output, and hemoptysis and was found to have anemia, acute kidney injury, and bilateral pulmonary infiltrates. Antibodies to cytoplasmic antinuclear cytoplasmic antibody (c-ANCA) and proteinase 3 (anti-PR3 Ab) were positive, and perinuclear antinuclear cytoplasmic antibody (p-ANCA) and antibodies to myeloperoxidase (anti-MPO Ab) were negative. A diagnosis of Wegener granulomatosis (WG) was made. His course was complicated by respiratory failure and renal failure requiring hemodialysis. Treatment consisted of cyclophosphamide (CYC), corticosteroids, plasmapheresis, and intravenous immunoglobulin (IVIG). Ultimately, dialysis was discontinued, and serum creatinine level (Cr) was stabilized at 1.6–1.8 g/dL 4 months after presentation. After 6 months, immunosuppression was changed from CYC to azathioprine, and prednisone was tapered and discontinued after 1 year.

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Author information

Authors and Affiliations

  1. Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh, A915 Scalfe Hall, 3550 Terrace Street, Pittsburgh, PA, 15261, USA

    Kelly V. Liang M.D.

  2. Rheumatology Division, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15261, USA

    Kimberly P. Liang M.D.

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  1. Kelly V. Liang M.D.
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  2. Kimberly P. Liang M.D.
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Correspondence to Kelly V. Liang M.D. .

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Editors and Affiliations

  1. Chicago College of Medicine, Nephrology, University of Illinois, Wisconsin Avenue 3543, Berwyn, 60402, Illinois, USA

    Edgar V. Lerma

  2. , Division of Nephrology, University of Virginia Health System, Box 800133, Charlottesville, 22908, Virginia, USA

    Mitchell Rosner

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Liang, K.V., Liang, K.P. (2013). Interpretation of Serologic Testing in Glomerular Diseases. In: Lerma, E., Rosner, M. (eds) Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4454-1_8

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  • DOI: https://doi.org/10.1007/978-1-4614-4454-1_8

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