Wegeners Granulomatosis Complicated by Intestinal Ulcer due to Cytomegalovirus Infection and by Thrombotic Thrombocytopenic Purpura

スポンサーリンク

概要

• 論文の詳細を見る

• A 61-year-old woman was admitted to our hospital because of acute kidney injury. She complained of general fatigue, appetite loss, and a high fever. Nodular lesions were observed on chest X-rays and there were >100 erythrocytes per high power field in her urinary sediment. A renal biopsy revealed necrotizing granulomatous glomerulonephritis, and her serum proteinase 3-antineutrophil cytoplasmic anitibody (PR3-ANCA) titer was elevated (55 EU). Based on these findings we made a diagnosis of Wegeners granulomatosis (WG). Hemodialysis was started immediately after admission. Steroid therapy was administered and her symptoms were relieved, but her renal function did not improve. On the 50th hospital day her condition suddenly became complicated by hemoperitoneum and massive intestinal bleeding, and the descending, transverse, ascending colon and part of the ileum were surgically resected. The cytomegalovirus (CMV) antigen titer was elevated, and histologic examination of the bowel specimen showed positive staining for CMV in the ulcer lesion, suggesting that CMV infection had caused the bowel hemorrhage. After treatment with ganciclovir, the bleeding was resolved and the CMV antigens became negative. We considered that this patient was further complicated by thrombotic thrombocytopenic purpura (TTP) because of thrombocytopenia, hemolytic anemia and neurologic symptoms. She was treated by plasma exchange. We report here a case of WG complicated by acute intestinal ulcer due to CMV infection and by TTP.

• 社団法人　日本内科学会の論文

著者

• SUZUKI Keiko

  Department of Internal Medicine, Koga General Hospital

• Honda Kazuho

  Department of Pathology,Tokyo Women's Medical University

• Uchida Keiko

  Department of Medicine, Kidney Center, Tokyo Womens Medical University

• Yumura Wako

  Department of Nephrology, Jichi Medical University

• Nitta Kosaku

  Department of Medicine, Kidney Center, Tokyo Womens Medical University

• TAKEI Takashi

  Department of Medicine, Kidney Center, Tokyo Women's Medical University

• TSUCHIYA Ken

  Department of Medicine, Kidney Center, Tokyo Women's Medical University

• Uchida Keiko

  Department Of Medicine Kidney Center Tokyo Women's Medical University

• Akiba Takashi

  Department Of Medicine Kidney Center Tokyo Women's Medical University

• Yumura W

  東京女子医科大学附属腎臓病総合医療センター 腎臓内科

• Yumura Wako

  Department Of Medicine Kidney Center Tokyo Women's Medical University

• Tsuchiya Ken

  東京女子医科大学附属腎臓病総合医療センター 腎臓内科

• Otsubo Shigeru

  Department Of Electrical Engineering Ishikawa National College Of Tecchnology Tsubata

• KOIKE Minako

  Department of Medicine, Kidney Center, Tokyo Women's Medical University

• Horita Shigeru

  Department of Medicine, Kidney Center, Tokyo Womens Medical University

• Yamazaki Mayuko

  Department of Medicine, Kidney Center, Tokyo Womens Medical University

• Iwasa Yuko

  Department of Medicine, Kidney Center, Tokyo Womens Medical University

• Yabuki Yasuko

  Department of Medicine, Kidney Center, Tokyo Womens Medical University

• Honda Kazuho

  Department Of Medicine Kidney Center Tokyo Women's Medical College

• Koike Minako

  Department Of Medicine Kidney Center Tokyo Women's Medical University

• Takei Takashi

  Department Of Applied Chemistry Graduate School Of Engineering Tokyo Metropolitan University

• Horita Shigeru

  Department Of Medicine Kidney Center Tokyo Women's Medical University

• Akiba Takashi

  Department Of Blood Purification And Department Of Urology Tokyo Medical And Dental University

• Nitta Kosaku

  Department Iv Of Internal Medicine Tokyo Women's Medical University

• Iwasa Yuko

  Department Of Medicine Iv Tokyo Women's Medical University

• Tsuchiya Ken

  Department Iv Of Internal Medicine Tokyo Women's Medical University

• Suzuki Keiko

  Deparment Of Cardiology Cenler For Adut Diseases Osaka

• OTSUBO Shigeru

  Department of Medicine, Kidney Center, Tokyo Women's Medical University

• Yabuki Yasuko

  Department of Medicine, Kidney Center, Tokyo Women's Medical University

• Otsubo Shigeru

  Department of Blood Purification, Sangenjaya Hospital, Japan

• Akiba Takashi

  Department of Blood Purification, Kidney Center, Tokyo Women's Medical University

関連論文

• Antiphospholipid Antibodies and Renal Outcomes in Patients with Lupus Nephritis
• PJ-189 Eicosapentaenoic Acid Attenuates Arterial Medial Calcification in the Vascular Calcification Model Rats through the Supression of Matrix Metalloproteinases(PJ032,Peripheral Circulation/Vascular Disease (Pathophysiology, Basic) 1 (H),Poster Session
• Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in Japan : a retrospective analysis of 1,057 cases from Kyushu Lymphoma Study Group
• Successful Treatment with Rituximab in a Patient with TTP Secondary to Severe ANCA-Associated Vasculitis
• A functional SNP in the NKX2.5-binding site of ITPR3 promoter is associated with susceptibility to systemic lupus erythematosus in Japanese population
• Identification of a significant association of a single nucleotide polymorphism in TNXB with systemic lupus erythematosus in a Japanese population
• The characteristics of relapse in adult-onset minimal-change nephrotic syndrome
• Association between Serum Adiponectin Levels and Arteriolosclerosis in IgA Nephropathy Patients
• Anti-Glomerular Basement Membrane Antibody Disease with Granulomatous Lesions on Renal Biopsy
• Wegeners Granulomatosis Complicated by Intestinal Ulcer due to Cytomegalovirus Infection and by Thrombotic Thrombocytopenic Purpura
• Association of a single-nucleotide polymorphism in the immunoglobulin μ-binding protein 2 gene with immunoglobulin A nephropathy
• Prolonged membranous lupus nephritis with change of anti-ssDNA antibody titer and repeated renal relapse
• Left Ventricular Hypertrophy Is Associated with Arterial Stiffness and Vascular Calcification in Hemodialysis Patients
• Association of single-nucleotide polymorphisms in the polymeric immunoglobulin receptor gene with immunoglobulin A nephropathy (IgAN) in Japanese patients
• Single-nucleotide polymorphisms in the class II region of the major histocompatibility complex in Japanese patients with immunoglobulin A nephropathy
• Retroperitoneal Fibrosis Associated with Membranous Nephropathy Effectively Treated with Steroids
• Clinical significance of histological grading and staging for predicting the effectiveness of steroid therapy in IgA nephropathy
• Clinical assessment of serum cystatin C as a marker of glomerular filtration rate in patients with various renal diseases
• Acute renal failure in a patient with hemophagocytic syndrome
• Decreased expression of vascular endothelial growth factor in glomeruli of puromycin aminonucleoside nephrosis
• Clinicopathological study of lgA nephropathy in adults: The influence of onset age on clinical and renal histological findings and on the effect of steroid therapy
• Clinical Practice Guidebook for Diagnosis and Treatment of Chronic Kidney Disease
• A case of Mikulicz's disease complicated with severe interstitial nephritis associated with IgG4
• PJ-756 Aliskiren Reduces Leukocyte Recruitment in Acute Vascular Inflammation via Oxidative Stress-dependent, but Blood Pressure Independent Mechanisms(PJ127,Intravascular Imagings 2 (I),Poster Session (Japanese),The 73rd Annual Scientific Meeting of The
• Arterial Stiffness in Patients with Non-Diabetic Chronic Kidney Disease (CKD)
• Aortic Arch Calcification and Arterial Stiffness are Independent Factors for Diastolic Left Ventricular Dysfunction in Chronic Hemodialysis Patients
• Low-Dose Losartan Therapy Reduces Proteinuria in Normotensive Patients with Immunoglobulin A Nephropathy
• Clinical assessment of low-dose steroid therapy for patients with IgA nephropathy : a prospective study in a single center
• PJ-224 Primal role of intracellular zinc in PKC-dependent monocyte signalling and adhesive interaction(Atherosclerosis, basic(06)(IHD),Poster Session(Japanese),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
• Patterns in the prevalence of hepatitis C virus infection at the start of hemodialysis in Japan
• Role of mitogen-activated protein kinase in the regulation of transforming growth factor-β-induced fibronectin accumulation in cultured renal interstitial fibroblasts
• Assessment of Coronary Artery Calcification in Hemodialysis Patients Using Multi-Detector Spiral CT Scan
• PJ-363 Functional Impacts of Selectin Haplotypes on Leukocyte-endothelial Interaction(Molecular Biology, Vascular 2 (H) : PJ61)(Poster Session (Japanese))
• Resistance of CD28-deficient mice to autologous phase of anti-glomerular basement membrane glomerulonephritis
• Prevalence of chronic kidney disease (CKD) in the Japanese general population predicted by the MDRD equation modified by a Japanese coefficient
• Analysis of the expression of cell surface antigens and intercellular adhesion molecules on lymphocytes in CAPD patients
• Chronic Kidney Disease Japan Cohort (CKD-JAC) Study : Design and Methods
• Nephrotic Syndrome Associated with Fibrillary Deposits in the Glomeruli
• Renal pathology of ANCA-related vasculitis : proposal for standardization of pathological diagnosis in Japan
• Successful Use of Single-Dose Rituximab for the Maintenance of Remission in a Patient with Steroid-Resistant Nephrotic Syndrome
• Effects of Lipid-Lowering Therapy with Rosuvastatin on Atherosclerotic Burden in Patients with Chronic Kidney Disease
• Monitoring of Blood Cyclosporine Concentration in Steroid-Resistant Nephrotic Syndrome
• Risk Factors for Progression in Patients with Early-stage Chronic Kidney Disease in the Japanese Population
• PJ-162 Significant Effects of EPA on Aortic Medial Calcification in the Vascular Calcification Model Rats(Peripheral circulation/Vascular disease(06)(H),Poster Session(Japanese),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
• Mast cells and tubulointerstitial fibrosis in patients with ANCA-associated glomerulonephritis
• Risedronate Therapy for the Prevention of Steroid-induced Osteoporosis in Patients with Minimal-change Nephrotic Syndrome
• PJ-227 Osteogenic Mechanism Plays a Significant Role in Aortic Medial Calcification(Atherosclerosis, basic(06)(IHD),Poster Session(Japanese),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
• Membranoproliferative Glomerulonephritis and Demyelinating Neuropathy Caused by Type II Mixed Cryoglobulinemia Associated with HCV Infection
• High glucose modulates albumin permeability across glomerular endothelial cells via a protein kinase C-dependent mechanism
• PJ-244 Relation of Oral 1 α-hydroxy Vitamin D3 to the Progression of Aortic Arch Calcification in Hemodialysis Patients(PJ041,Atherosclerosis (Clinical/Pathophysiology/Treatment/Diagnosis) (IHD),Poster Session (Japanese),The 73rd Annual Scientific Meeting
• Associations between vascular calcification, arterial stiffness and bone mineral density in chronic hemodialysis patients
• Pharmacological Topics of Bone Metabolism : A Novel Bisphosphonate for the Treatment of Periodontitis
• Current Topics in Pharmacological Research on Bone Metabolism : Inhibitory Effects of Bisphosphonates on the Differentiation and Activity of Osteoclasts
• Risedronate Does Not Interfere with Bone Formation Coupled with Lipopolysaccharide-Stimulated Bone Resorption
• Dynamic Computer Tomography Is Useful in the Differential Diagnosis of Juxtaglomerular Cell Tumor and Renal Cell Carcinoma
• Effects of long-term transdermal hormone replacement therapy on the renin-angiotensin-aldosterone system, plasma bradykinin levels and blood pressure in normotensive postmenopausal women
• Multifocal Electroretinogram in Patients with Central Serous Chorioretinopathy
• Correlation between EGFR gene mutation pattern and Akt phosphorylation in pulmonary adenocarcinomas
• A Novel Mouse Model for MPO-ANCA-Associated Glomerulonephritis
• Interaction between adrenomedullin and angiotensin II in DNA synthesis and extracellular matrix accumulation in cultured rat kidney interstitial cells
• Effect of Prednisolone Therapy on Serum Concentrations of Soluble Interleukin-2 Receptor in Patients with IgA Nephropathy
• Effect of Beraprost Sodium on DNA Synthesis in Cultured Bovine Mesangial Cells
• Dok-1 and Dok-2 are negative regulators of T cell receptor signaling
• evidence-based practice guideline for the treatment of chronic kidney disease
• LOCALIZATION OF SUDANOPHIL MATERIAL AT THE SITES OF CALCIFICATION IN DENTINE. AND THE COMPACT BONE AND EPIPHYSEAL CARTILAGE PLATE OF TIBIA IN THE RAT GIVEN BERYLLIUM CARBONATE
• Prognostic impact of immunohistochemical biomarkers in diffuse large B-cell lymphoma in the rituximab era
• A nationwide survey of rapidly progressive glomerulonephritis in Japan : etiology, prognosis and treatment diversity
• Molecular embryology for an understanding of congenital heart diseases
• Difference of myosin heavy chain expression between mesangial cells and vascular smooth muscles
• CT Features of Pulmonary Nontuberculous Mycobacterial Infection:Effects of Underlying Pulmonary Disease
• Attenuation of Cardiac Hypertrophy in Carnitine-Deficient Juvenile Visceral Steatosis (JVS) Mice Achieved by Lowering Dietary Lipid
• Involvement of Adhesion Molecules in Glomerular Endothelial Cell Injury Induced by PMA-Stimulated Lymphocytes
• Expression of intercellular adhesion molecule-1 on cultured glomerular endothelial cells by pro-inflammatory cytokines and lipopolysaccharide
• Colony-Stimulating Factor-1 (CSF-1) Induces Osteopontin mRNA Expression in Cultured Rat Osteoclasts
• Prolonged membranous lupus nephritis with change of anti-ssDNA antibody titer and repeated renal relapse
• The change in wettability and structure of silica powder surfaces modified with hexamethyldisilazane
• A conformation study of normal alkoxy groups introduced on to a silica surface
• The change in the water vapor affinity of fine silica particles loaded with trimethylsilyl groups
• Effect of GLP-1 (Glucagon-like Peptide 1:7-36 Amide) on Porcine Pancreatic Endocrine Cell Proliferation and Insulin Secretion
• Vectorcardiogram in Biventricular Hypertrophy with the Frank System
• True and False Left Anterior Hemiblock : Vectorcardiographic Study
• Hypercalcemic-type ovarian small cell carcinoma with unique CD34 expression
• Phosphorylation status of nephrin in human membranous nephropathy
• Serum Cystatin C Concentration as a Marker of Glomerular Filtration Rate in Patients with Various Renal Diseases
• Clinical assessment of atherosclerotic parameters and cardiac function in chronic hemodialysis patients
• Aortic Arch Calcification and Clinical Outcome in Patients with End-Stage Renal Disease
• Diagnosis of toxic shock syndrome by two different systems : clinical criteria and monitoring of TSST-1-reactive T cells
• Analysis of Plasma Adipocytokines Related to Clinical and Laboratory Data in the Maintenance Hemodialysis Patients
• Ruptured Arterial Aneurysm of the Kidney in a Patient with Microscopic Polyangiitis
• Analysis of Lupus Activity in End-Stage Renal Disease Treated by Hemodialysis
• Dexamethasone increases the phosphorylation of nephrin in cultured podocytes
• Long-term beneficial effects of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker therapy for patients with advanced immunoglobulin A nephropathy and impaired renal function
• Risk Factors for Vitamin D Deficiency in Patients with Chronic Kidney Disease
• Rituximab Treatment for Adult Patients with Focal Segmental Glomerulosclerosis
• Severity-based treatment for Japanese patients with MPO-ANCA-associated vasculitis : the JMAAV study
• Recent advances in the treatment of lupus nephritis
• Comparison of inhibitors of renin-angiotensin-aldosterone system (RAS) and combination therapy of steroids plus RAS inhibitors for patients with advanced immunoglobulin A nephropathy and impaired renal function
• Effects of Combination Therapy with Renin-Angiotensin System Inhibitors and Eicosapentaenoic Acid on IgA Nephropathy
• Clinical and Pathological Studies of IgA Nephropathy Presenting as a Rapidly Progressive Form of Glomerulonephritis
• Positive C1q staining associated with poor renal outcome in membranoproliferative glomerulonephritis

もっと見る 閉じる

スポンサーリンク