Rapidly progressive glomerulonephritis associated to afebrile endocarditis and anti-proteinasa 3 anca
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| Format: | Artículo científico |
| Language: | en |
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Asociación Colombiana de Nefrología e Hipertensión Arterial
2017
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| author | Esmeralda Castillo Rodríguez |
| author_facet | Esmeralda Castillo Rodríguez |
| contents | Rapidly progressive glomerulonephritis associated to afebrile endocarditis and anti-proteinasa 3 anca Esmeralda Castillo Rodríguez Diana Pazmiño Zambrano Pablo Manrique de Lara Cadiñanos Laura Rodríguez-Osorio Pablo Cannata Carolina Gracia Iguacel Raquel Alegre Jesús Egido Alberto Ortiz Emilio González Parra Medicina ANCA antiPR3 Endocarditis Postinfectious Necrotizing glomerulonephritis poststreptococcal glomerulonephritis Endocarditis associated with antiPR3 ANCA and acute kidney injure generates a challenge in its diagnosis and treatment. In order to make a review about that combination, we presented a patient with necrotizing glomerulonephritis produced by a Enterococcus faecalis's subacute endocarditis and antiPR3 ANCA positive.Differential diagnosis is made between an acute kidney failure produced by ANCA's vasculitis vs necrotizing glomerulonephritis by endocarditis. Frequently it is necessary to make a biopsy to get a diagnosis. Negative immunofluorescence will guide to vasculitis associated ANCA, while positive immune complexes will guide to poststreptococcal glomerulonephritis.Other challenge that generates the association of acute kidney disease, endocarditis and antiPR3 ANCA is the treatment. ANCA positive can prompt to start immunosuppressant treatments. However, in the context of endocarditis, it could be inadvisable and even dangerous to use it. For this reason, it is controversial the use of immunosuppressant in combination with antibiotics in the acute process, in contrast with the use of only antibiotics. In the current paper we collect the 19 reports in the literature about endocarditis associated with antiPR3 ANCA, the treatment and the renal evolution of each patient. We concluded, generally, a better improvement of kidney function in patients treated with only antibiotics than those patients treated with the combination of antibiotics and corticoids. However, there are so few reports that we can't consider significant the different between both treatment groups. 2017 otro 2389-7708 https://www.redalyc.org/articulo.oa?id=560159495008 https://www.redalyc.org/journal/5601/560159495008/ https://www.redalyc.org/journal/5601/560159495008/html/ https://www.redalyc.org/journal/5601/560159495008/560159495008.epub https://www.redalyc.org/journal/5601/560159495008/movil 10.22265/acnef.4.1.258 en http://www.redalyc.org/revista.oa?id=5601 Revista Colombiana de Nefrología application/pdf Asociación Colombiana de Nefrología e Hipertensión Arterial Revista Colombiana de Nefrología (Colombia) Num.1 Vol.4 |
| format | Artículo científico |
| id | redalyc_560159495008 |
| institution | Redalyc |
| language | en |
| publishDate | 2017 |
| publisher | Asociación Colombiana de Nefrología e Hipertensión Arterial |
| spellingShingle | Rapidly progressive glomerulonephritis associated to afebrile endocarditis and anti-proteinasa 3 anca Esmeralda Castillo Rodríguez Medicina ANCA antiPR3 Endocarditis Postinfectious Necrotizing glomerulonephritis poststreptococcal glomerulonephritis Rapidly progressive glomerulonephritis associated to afebrile endocarditis and anti-proteinasa 3 anca Esmeralda Castillo Rodríguez Diana Pazmiño Zambrano Pablo Manrique de Lara Cadiñanos Laura Rodríguez-Osorio Pablo Cannata Carolina Gracia Iguacel Raquel Alegre Jesús Egido Alberto Ortiz Emilio González Parra Medicina ANCA antiPR3 Endocarditis Postinfectious Necrotizing glomerulonephritis poststreptococcal glomerulonephritis Endocarditis associated with antiPR3 ANCA and acute kidney injure generates a challenge in its diagnosis and treatment. In order to make a review about that combination, we presented a patient with necrotizing glomerulonephritis produced by a Enterococcus faecalis's subacute endocarditis and antiPR3 ANCA positive.Differential diagnosis is made between an acute kidney failure produced by ANCA's vasculitis vs necrotizing glomerulonephritis by endocarditis. Frequently it is necessary to make a biopsy to get a diagnosis. Negative immunofluorescence will guide to vasculitis associated ANCA, while positive immune complexes will guide to poststreptococcal glomerulonephritis.Other challenge that generates the association of acute kidney disease, endocarditis and antiPR3 ANCA is the treatment. ANCA positive can prompt to start immunosuppressant treatments. However, in the context of endocarditis, it could be inadvisable and even dangerous to use it. For this reason, it is controversial the use of immunosuppressant in combination with antibiotics in the acute process, in contrast with the use of only antibiotics. In the current paper we collect the 19 reports in the literature about endocarditis associated with antiPR3 ANCA, the treatment and the renal evolution of each patient. We concluded, generally, a better improvement of kidney function in patients treated with only antibiotics than those patients treated with the combination of antibiotics and corticoids. However, there are so few reports that we can't consider significant the different between both treatment groups. 2017 otro 2389-7708 https://www.redalyc.org/articulo.oa?id=560159495008 https://www.redalyc.org/journal/5601/560159495008/ https://www.redalyc.org/journal/5601/560159495008/html/ https://www.redalyc.org/journal/5601/560159495008/560159495008.epub https://www.redalyc.org/journal/5601/560159495008/movil 10.22265/acnef.4.1.258 en http://www.redalyc.org/revista.oa?id=5601 Revista Colombiana de Nefrología application/pdf Asociación Colombiana de Nefrología e Hipertensión Arterial Revista Colombiana de Nefrología (Colombia) Num.1 Vol.4 |
| title | Rapidly progressive glomerulonephritis associated to afebrile endocarditis and anti-proteinasa 3 anca |
| topic | Medicina ANCA antiPR3 Endocarditis Postinfectious Necrotizing glomerulonephritis poststreptococcal glomerulonephritis |
| url | https://www.redalyc.org/articulo.oa?id=560159495008 https://www.redalyc.org/journal/5601/560159495008/ https://www.redalyc.org/journal/5601/560159495008/html/ https://www.redalyc.org/journal/5601/560159495008/560159495008.epub https://www.redalyc.org/journal/5601/560159495008/movil |