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Kidney Week

Abstract: PO0136

Case of Paraneoplastic Pauci-Immune Glomerulonephritis

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Jafari, Golriz, UCLA Medical Center Olive View, Sylmar, California, United States
  • Mahmood, Masood, UCLA Medical Center Olive View, Sylmar, California, United States
  • Kamarzarian, Anita, UCLA Medical Center Olive View, Sylmar, California, United States
Introduction

This case highlights the importance of complete systemic evaluation for patients presenting with rapidly progressive glomerulonephritis (RPGN).

Case Description

58 year old male with history of DM type 2 and hypothyroidism presents with acute kidney injury (AKI). Notable findings include a rash which was biopsied and due to leukocytoclastic vascullitis. Baseline Cr 0.59 mg/dl and continued to increase rapidly leading to patient becoming hemodialysis dependent. Urine showed an active sediment; serology including ANCA and anti-GBM were all negative. Patient was empirically started on steroids for possible Immunoglobulin A glomerulonephritis and also due to diagnosis of adrenal insufficiency. Renal biopsy subsequently showed pauci-immune crescentic glomerulonephritis with 89% og glomeruli with crescents, 74% of which are active and negative immunefluorescence. Patient was started on cytoxan. However further work up revealed a inguinal mass which was biopsied and found to be Hodgkin's lymphoma. Patient was started on chemotherapy however did not make any renal recovery and remains dialysis dependent.

Discussion

This case illustrates the importance of thorough evaluation in patients presenting with rapidly progressive glomeronephritis. Although ofent times it is due to a primary renal or renal/pulmonary disorder, paraneoplastic conditions should not be overlooked and need further investigation.