Microscopic polyangeitis as cause of rapidly progressive glomerulonephritis in a geriatric patient: a case study

Abstract

Objective: To report a case of diagnosis of microscopic polyangiitis, in an elderly patient, in the context of rapidly progressive glomerulonephritis. Case details: Patient 75 years old, previously diabetic and hypertensive, with a history of adynamia and diffuse myalgia for 2 months, associated with daily subfebrile peaks. Admitted to a tertiary hospital, physical examination showed no relevant changes, laboratory tests with evidence of anemia, leukocytosis, elevation of C-reactive protein, alteration of renal slag, with no report of previous kidney disease, routine urinalysis with hematuria and subnephrotic proteinuria. Extensive workup was performed with evidence of altered rheumatological markers and positive P-ANCA (Antineutrophil Cytoplasmic Antibody) in high titers. In addition to performing a renal biopsy showing histology compatible with Microscopic Polyangiitis. Pulse therapy with methylprednisolone and cyclophosphamide was performed. Patient did not need to start renal replacement therapy. He was discharged after the therapy performed, with improvement in renal function. Final considerations: Positive ANCA Glomerulopathies should be considered as a differential diagnosis of Acute Kidney Injury (AKI), especially in a rapidly progressive context, including in the elderly population. Early diagnosis allows immediate treatment, reducing morbidity and providing a better quality of life.