A case of myeloperoxidase-antineutrophil cytoplasmic autoantibody (MPO-ANCA) -associated glomerulonephritis who was discovered by school urinalysis

Abstract

  We reported a case of anti-neutrophil cytoplasmic autoantibody-associated glomerulonephritis which was seemed to be valuable to know the initial stage.
  A fifteen year-old-boy was pointed out proteinuria and hematuria by school urinalysis at seven years old. Abnormal urinalysis was disappeared when he was nine years old, but was pointed out again by school urinalysis when he was thirteen years old in April 1999. He was referred to our hospital. The first renal biopsy specimen showed segmental sclerosis in one of five glomeruli. Anti-platelet therapy was started. However, proteinuria increased and the levels of creatinine in serum elevated rapidly since April 2000. The second renal biopsy was performed in May 2000, because of elevated serum MPO-ANCA levels (304EU). Fibro-cellular crescent were present in seven of nine glomeruli in this specimen. Therefore, he was diagnosed as crescentic glomerulonephritis of the pauci-immune type. The levels of MPO-ANCA and creatinine in serum decreased after the methylprednisolone pulse therapy and subsequent oral prednisolone therapy was performed. The urinalysis was improved.
  In a pupil discovered proteinuria and hematuria by school urinalysis, we should measure ANCA positively.