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ISSN: 1426-3912
Central European Journal of Immunology
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vol. 48
Case report

An unusual cause of rapidly progressive glomerulonephritis associated with ANCA vasculitis and ovarian malignancy – a relapse 39 years after initial treatment

Nikola Simovic
Petar Djuric
1, 2
Jelena Stojsic
Nada Dimkovic
Radomir Naumovic
1, 2

Department of Nephrology and Hemodialysis, Zvezdara University Medical Center, Belgrade, Serbia
School of Medicine, University of Belgrade, Serbia
Department of Histopathology, University Clinical Center of Serbia, Belgrade, Serbia
Cent Eur J Immunol 2023; 48 (2): 163-166
Online publish date: 2023/07/18
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A 69-year-old woman presented with severe anemia, proteinuria, microscopic hematuria and rapidly progressive renal failure. She was admitted to the nephrology department due to severe deterioration of renal function with complaints of malaise, fever, dry cough and occasional epistaxis that appeared 2 months prior to admission. Histopathologic examination of a specimen from kidney biopsy and immunologic findings revealed ANCA positive pauci-immune crescentic glomerulonephritis. The patient had a history of ovarian granulosa cell tumor and lung metastases that were treated surgically with postoperative radiotherapy and chemotherapy. Thoracic computed tomography showed tissue neoplasm in the right lung and ultrasound-guided percutaneous transthoracic biopsy confirmed granulosa cell tumor. That was a relapse, thirty-nine years after initial treatment of malignant disease and twenty-four years after surgical resection of metastases from both lungs. Although the association between malignancy and vasculitis has been well known for decades, this is the first described case of ANCA vasculitis associated with any type of gynecological malignancy and glomerulonephritis.

glomerulonephritis, granulosa cell tumor, ANCA associated vasculitis

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