An Unusual Presentation of Classic Idiopathic Polyarteritis Nodosa as Acute Interstitial Nephritis. Issue 6 (January 2013)

• Record Type: Journal Article
• Authors: Sunderkrishnan, Ravi; Bodukam, Vijay; Tiwana, Manpreet; Tadi, Prasanna; Okechukwu, Nathan C.
• Is Part Of: Clinical medicine insights. Issue 6(2013)
• Publication Date: 2013-01
• Subjects: classic polyarteritis nodosa -- acute interstitial nephritis -- microscopic polyangiitis -- renal biopsy -- eosinophiluria -- MPO-ANCA; Clinical medicine -- Case studies -- Periodicals; Medicine; Clinical medicine; Electronic journals; Case Reports; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; Case studies; Periodicals; 616.09
• DOI: 10.4137/CCRep.S11520
• Languages: English
• ISSNs: 1179-5476

Abstract

In the medical literature, there have been few reported cases of classic Polyarteritis Nodosa (cPAN) presenting with acute renal failure (ARF) and, unlike microscopic polyangiitis (MPA), no documentation to our knowledge of cPAN with clinical presentation similar to acute interstitial nephritis. We describe a case of ARF and a clinical picture suggestive of acute interstitial nephritis (AIN). However, renal biopsy of this patient showed acute necrotizing intrarenal vasculitis, suggestive of cPAN. Although no guidelines exist for the most appropriate therapy for patients presenting in this fashion, combination therapy with cyclophosphamide and steroids, in our patient, resulted in clinical improvement and resolution of dialysis-dependent renal failure. These findings suggest the potential for good prognosis in patients with cPAN who present with a presumed diagnosis of AIN and dialysis-dependent ARF.