Rapidly Progressive Glomerulonephritis Associated with PR3-ANCA Positive Subacute Bacterial Endocarditis

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概要

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• Patients with bacterial endocarditis often have renal complications. This report presents the case of an elderly man with rapidly progressive glomerulonephritis (RPGN) associated with subacute bacterial endocarditis (SBE) due to Enterococcus faecalis infection. The patient was positive for anti-proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) and rheumatoid factor (RF) with hypocomplementemia. Treatment for SBE with antibiotics and the surgical replacement of the affected valves resulted in an improvement of RPGN, the disappearance of PR3-ANCA and RF, and the normalization of hypocomplementemia. This rare case suggests the importance of recognizing the cause of positive PR3-ANCA, because SBE could be an occult cause of RPGN mimicking ANCA-associated vasculitis.

著者

• Fujigaki Yoshihide

  First Department Of Medicine Hamamatsu University School Of Medicine

• Kinoshita Naoko

  Renal Division Department Of Internal Medicine Iwata City Hospital

• Furuya Ryuichi

  Renal Division Department Of Internal Medicine Iwata City Hospital

• Fukasawa Hirotaka

  Renal Division Department Of Internal Medicine Iwata City Hospital

• Sakao Yukitoshi

  Hemodialysis Unit, Hamamatsu University School of Medicine, Japan

• Hayashi Maho

  Renal Division, Department of Internal Medicine, Iwata City Hospital, Japan

• Ishigaki Sayaka

  Renal Division, Department of Internal Medicine, Iwata City Hospital, Japan

• Isobe Shinsuke

  First Department of Medicine, Hamamatsu University School of Medicine, Japan

• Kato Akihiko

  Hemodialysis Unit, Hamamatsu University School of Medicine, Japan

• Fujigaki Yoshihide

  First Department of Medicine, Hamamatsu University School of Medicine, Japan

• Kinoshita Naoko

  Renal Division, Department of Internal Medicine, Iwata City Hospital, Japan

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