Membranous nephropathy with crescents associated with levamisole-induced MPO-ANCA vasculitis

详细信息    查看全文

• 作者：Irfan Moinuddin^a ; ^{irfanmoinuddin@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; ^{irfanmoinuddin@deptofmed.arizona.edu" class="auth_mail" title="E-mail the corresponding author} ; Machaiah Madhrira^a ; ^{mmadhrira@swkidney.com" class="auth_mail" title="E-mail the corresponding author} ; Erika Bracamonte^b ; ^{erikab@pathology.arizona.edu" class="auth_mail" title="E-mail the corresponding author} ; Bijin Thajudeen^a ; ^{bijint@deptofmed.arizona.edu" class="auth_mail" title="E-mail the corresponding author} ; Amy Sussman^a ; ^{asussman@deptofmed.arizona.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Levamisole ; Crescentic ; Membranous ; Pauciimmune ; Vasculitis ; Glomerulonephritis
• 刊名：Pathology - Research and Practice
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：212
• 期：7
• 页码：650-653
• 全文大小：1769 K

文摘

ANCA-associated vasculitis (AAV) is the most common cause of crescentic rapidly progressive glomerulonephritis (GN). Levamisole used as an adulterant in cocaine is increasingly recognized as a cause of AAV. We report the case of a 50 year old woman with atypical anti-MPO AAV associated with cocaine use and exposure to levamisole. In addition to the clinical and pathologic findings of crescentic GN, the patient also had biopsy evidence of secondary membranous nephropathy (MN). Although AAV and MN have been reported previously in the same patient and both have been induced by drug exposures, this is the first report of MN in a patient with AAV likely induced by levamisole. We suggest that MPO can cause both pauci-immune vasculitis and secondary membranous nephropathy in some cases, as in cases of levamisole-adulterated cocaine use.