• Users Online: 72
  • Print this page
  • Email this page
Year : 2021  |  Volume : 10  |  Issue : 2  |  Page : 83-86

“Triple-positive” renal limited vasculitis presenting with rapidly progressive glomerulonephritis: A case report

1 Department of Medicine, Jawaharlal Nehru Medical College, DMIMS (Deemed to be University), India
2 Department of Pathology, Jawaharlal Nehru Medical College, DMIMS (Deemed to be University), India

Correspondence Address:
Amol Andhale
Department of Medicine, Jawaharlal Nehru Medical College, DMIMS (Deemed to be University)
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2221-6189.312215

Get Permissions

Rationale: Coexistence of anti-glomerular basement membrane (anti-GBM) disease with anti-neutrophil cytoplasmic antibody (ANCA) in a case of glomerulonephritis is often identified as a “double-positive” disease. Interestingly, the majority of “double positive” ANCA is myeloperoxidase (MPO)-ANCA and some of the MPO-ANCA positive cases showed intrarenal arteritis, suggesting an ANCA-associated kidney lesion. Proteinase 3-ANCA positive diseases are also rarely reported. Patients positive for all three antibodies, i.e., triple-positive patients, are extremely rare. Patient’s Concern: A 53 year-old female presented with anasarca and oliguria of 2 months’ duration. Diagnosis: Pauci-immune type renal limited crescentic glomerulonephritis positive for MPO-ANCA, proteinase 3-ANCA, and anti-GBM antibody (triple-positive). Interventions: Intravenous high dose cyclophosphamide, oral azathioprine, intravenous methylprednisolone, and plasma exchange as per British Health Professionals in Rheumatology Guidelines. Outcomes: After one-month follow-up, anasarca and proteinuria were lessened, serum creatinine was normalized, titers of MPO-ANCA levels were decreased, and anti-GBM antibody levels were normalized. Lessons: Triple-positive renal limited vasculitis is rare and response to combined immunosuppressive therapy and plasma exchange can contribute to successful remission.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded28    
    Comments [Add]    

Recommend this journal