Rapidly progressive glomerulonephritis in rheumatoid arthritis: an early presentation of ANCA-associated vasculitis.
Jegadis Sreeneyasan, Roberta Dewar, Seema Rana et al.
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Case in brief
A 68-year-old man with newly diagnosed seropositive rheumatoid arthritis presented with rapidly progressive glomerulonephritis just six months after his arthritis diagnosis. His renal function deteriorated acutely, leading to the detection of positive myeloperoxidase (MPO)-ANCA serology and a renal biopsy that confirmed pauci-immune necrotising crescentic glomerulonephritis. The condition was managed effectively following diagnosis.
Diagnostic / clinical pearl
Clinicians should consider ANCA-associated vasculitis in patients with rheumatoid arthritis who experience acute kidney injury, even if the autoimmune condition is newly diagnosed.