Development of myeloperoxidase-antineutrophil cytoplasmic antibody-associated renal vasculitis in a patient receiving treatment with anti-tumor necrosis factor-α

Vol.20 No.6

Case Report

Development of myeloperoxidase-antineutrophil cytoplasmic antibody-associated renal vasculitis in a patient receiving treatment with anti-tumor necrosis factor-α

Authors

Daigoro Hirohama¹ , Junichi Hoshino¹ , Eiko Hasegawa¹ , Masayuki Yamanouchi¹ , Noriko Hayami¹ , Tatsuya Suwabe¹ , Naoki Sawa¹ , Fumi Takemoto¹ , Yoshifumi Ubara¹ , Shigeko Hara² , Kenichi Ohashi³ , Kenmei Takaichi¹

Kidney Center, Toranomon Hospital, 2-2-2 Toranomon, Minato Ward, Tokyo 105-8470, Japan
Health Management Center, Toranomon Hospital, Tokyo, Japan
Department of Pathology, Toranomon Hospital, Tokyo, Japan

Received:

2 April 2010

Accepted:

1 July 2010

Published online:

4 August 2010

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Abstract

We report on a 33-year-old woman who presented with positive myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) during rheumatoid arthritis treatment with infliximab. She had a history of worsening arthralgia, and urinalysis showed the new occurrence of hematuria and proteinuria. Renal biopsy showed necrotizing crescentic glomerulonephritis. Immunosuppressive therapy and discontinuation of the infliximab therapy alleviated her arthralgia and improved the urinalysis results. We report this rare case in which an anti-tumor necrosis factor-α (TNF-α) agent for ANCA-associated systemic vasculitis was studied.

Key words

TNF-α inhibitors - Infliximab - ANCA-associated systemic vasculitis - MPO-ANCA - Necrotizing crescentic glomerulonephritis