Nanke Yuki
Department School of Nursing, School of Nursing Position Professor |
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Article types | Case report |
Language | English |
Peer review | Peer reviewed |
Title | Rapidly progressive glomerulonephritis with D-penicillamine. |
Journal | Formal name:The American journal of the medical sciences Abbreviation:Am J Med Sci ISSN code:(0002-9629)0002-9629(Linking) |
Domestic / Foregin | Foregin |
Volume, Issue, Page | 320(6),pp.398-402 |
Author and coauthor | Nanke Y, Akama H, Terai C, Kamatani N |
Publication date | 2000/12 |
Summary | We present 3 cases of anti-myeloperoxidase, anti-neutrophil cytoplasmic antibody (MPO-ANCA)-positive rapidly progressive glomerulonephritis developed during the treatment with D-penicillamine (D-PC) for rheumatoid arthritis. Rheumatoid arthritis was diagnosed in these patients, and D-PC was administered to them at doses of 100, 200, and 300 mg per day for 32, 42, and 39 months, respectively. They developed proteinuria, hematuria, renal insufficiency, and anemia, and D-PC was stopped. On admission, MPO-ANCA was strongly positive in their sera. Renal biopsy showed glomerulonephritis with cellular crescents. Immunofluorescence examination revealed deposits of granular IgG, IgM, IgA, C1q, and C3 in the mesangium. The 3 patients were treated with steroid pulse therapy along with administration of anticoagulants, and cyclophosphamide was also used in 2 patients. Their renal function improved gradually and MPO-ANCA disappeared after immunosuppressive treatment. |
DOI | 10.1097/00000441-200012000-00008 |
PMID | 11149553 |