Open AccessAntineutrophil Cytoplasmic Autoantibody-Associated Vasculitis with Kidney Involvement in a Patient with AL Amyloidosis
Author(s) -
Thoms Brendan L.,
Agrawal Varun,
Umyarova Elvira R.,
Gibson Pamela C.,
Solomon Richard J.
Publication year - 2021
Publication title -
case reports in nephrology and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.278
H-Index - 7
ISSN - 2296-9705
DOI - 10.1159/000517142
Subject(s) - single case
AbstractAntineutrophil cytoplasmic autoantibody (ANCA) vasculitis has occasionally been associated with other systemic glomerulonephritis, such as anti-glomerular basement membrane disease. Here, we report the first clinical case of ANCA-associated crescentic glomerulonephritis with AL amyloidosis. An 81-years-old gentleman presented to the hospital with acute kidney injury (serum creatinine 4.7 mg/dL) on a background of chronic kidney disease and volume overload. Autoimmune serology was remarkable for p-ANCA and myeloperoxidase positivity. A renal biopsy confirmed pauci-immune glomerulonephritis and lambda light-chain amyloid deposition (confirmed on liquid chromatography and tandem mass spectrometry). The patient was initially managed with rituximab and subsequently transitioned to bortezomib-based chemotherapy but died due to decompensated heart failure. This case report promotes greater awareness of the unusual presentation of amyloidosis and guides future research and treatment.