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Nephrol Dial Transplant (2003) 18: 610-612
© 2003 European Renal Association-European Dialysis and Transplant Association

Case Report

A favourable outcome using oral prednisolone and losartan only in a patient with ANCA-related glomerulonephritis: a discrepancy between histological activity and MPO-ANCA

Hajime Nakahama1,, Osamu Sasaki1, Fumiki Yoshihara1, Satoko Nakamura1, Takashi Inenaga1, Yuhei Kawano1 and Hatsue Ueda2

1 Division of Hypertension and Nephrology and 2 Division of Pathology, National Cardiovascular Center, Suita, Japan

Keywords: ANCA-related glomerulonephritis; histology; losartan; minimal-change nephropathy; prednisolone; renal biopsy

The first 10% of the full text of this article appears below.



   Introduction
 
Antineutrophil cytoplasmic antibodies (ANCA) are usually diagnostic of pauci-immune crescentic glomerulonephritis. Pauci-immune crescentic glomerulonephritis often has a poor prognosis if not treated aggressively with immunosuppressants. A combination of high doses of corticosteroid and cyclophosphamide has been recommended as an induction therapy. Such therapy is not, however, without severe side-effects.

We report a patient with biopsy-documented minimal-change nephropathy associated with a high myeloperoxidase (MPO)-ANCA titre, who responded favourably to moderate doses of oral prednisolone and losartan, an angiotensin II receptor antagonist. This case suggests that the therapy of ANCA-related glomerulonephritis could be adjusted according to the activity of the disease observed on renal histology.



   Case
 
A 70-year-old male was admitted to our hospital in October 1999 because of persistent proteinuria and microhaematuria. . . . [Full Text of this Article]



   Discussion
 

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