[Acute on chronic renal failure in a 62-year-old man with ANCA-associated vasculitis]

C Schroeder; H Schenk; A Khalifa; J H Braesen; S von Vietinghoff

doi:10.1007/s00108-019-0657-9

[Acute on chronic renal failure in a 62-year-old man with ANCA-associated vasculitis]

Internist (Berl). 2019 Oct;60(10):1106-1110. doi: 10.1007/s00108-019-0657-9.

[Article in German]

Authors

C Schroeder¹, H Schenk¹, A Khalifa², J H Braesen², S von Vietinghoff³

Affiliations

¹ Klinik für Nieren- und Hochdruckerkrankungen, OE 6840, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland.
² Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland.
³ Klinik für Nieren- und Hochdruckerkrankungen, OE 6840, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland. vonvietinghoff.sibylle@mh-hannover.de.

PMID: 31435719
DOI: 10.1007/s00108-019-0657-9

Abstract

We describe a patient with ANCA (antineutrophil cytoplasmic antibodies) associated vasculitis and acute-on-chronic renal failure. He had initially presented with severe pulmonary hemorrhage and anuric renal failure and improved rapidly with immunosuppressive therapy. Repeat renal biopsy revealed candida interstitial nephritis. Candida was also detected in bronchoalveolar lavage. Kidney function improved with long-term antifungal therapy. This report adds induction therapy for ANCA vasculitis to the conditions where invasive candidal infections including nephritis need to be considered.

Keywords: Candida nephritis; Candida parapsilosis; Cyclophosphamide; Immunosuppression; Mycoses, invasive.

Publication types

Case Reports

MeSH terms

Acute Disease
Acute Kidney Injury
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / complications
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / drug therapy*
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / microbiology
Antibodies, Antineutrophil Cytoplasmic / immunology
Antifungal Agents / therapeutic use*
Biopsy
Candida / classification
Candida / isolation & purification*
Candidiasis / diagnosis
Candidiasis / drug therapy
Cyclophosphamide / therapeutic use
Humans
Immunosuppressive Agents / therapeutic use
Kidney Failure, Chronic / diagnosis*
Kidney Failure, Chronic / microbiology
Male
Middle Aged
Nephritis, Interstitial / drug therapy
Nephritis, Interstitial / pathology
Treatment Outcome

Substances

Antibodies, Antineutrophil Cytoplasmic
Antifungal Agents
Immunosuppressive Agents
Cyclophosphamide