Successful induction of granulomatosis with polyangiitis with tacrolimus
We report a 50-year-old female who presented with inflammatory arthritis, upper respiratory tract symptoms, and microscopic hematuria with nephrotic range proteinuria. Antineutrophil cytoplasmic antibodies (ANCA) were detectable and kidney biopsy showed pauci-immune focal necrotizing crescentic glom...
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doaj-1e13c10995194ef7b5971a0b86e6be0c2020-11-24T23:21:53ZengWolters Kluwer Medknow PublicationsIndian Journal of Nephrology0971-40651998-36622015-01-01251464910.4103/0971-4065.136885Successful induction of granulomatosis with polyangiitis with tacrolimusR RamachandranS TiwanaD PrabhakarK GowdaR NadaV KumarM RathiH S KohliV JhaK L GuptaV SakhujaWe report a 50-year-old female who presented with inflammatory arthritis, upper respiratory tract symptoms, and microscopic hematuria with nephrotic range proteinuria. Antineutrophil cytoplasmic antibodies (ANCA) were detectable and kidney biopsy showed pauci-immune focal necrotizing crescentic glomerulonephritis. She was treated with pulse intravenous cyclophosphamide (CYC) and prednisolone. Patient developed severe leucopenia after the first dose and subsequently had leucopenia to low dose CYC, mycophenolate mofetil and azathioprine were also tried. However, patient developed leukopenia with all the above agents. Initiation of tacrolimus (TAC) was followed by dramatic response: Proteinuria decreased, serum albumin normalized and C-ANCA and anti-PR3 ANCA assays became negative. This is the first successful case of TAC as an induction agent in a patient with GPA (ANCA associated vasculitis with renal involvement).http://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2015;volume=25;issue=1;spage=46;epage=49;aulast=RamachandranAntineutrophil cytoplasmic antibodiesassociated vasculitisgranulomatosis with polyangiitis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
R Ramachandran S Tiwana D Prabhakar K Gowda R Nada V Kumar M Rathi H S Kohli V Jha K L Gupta V Sakhuja |
spellingShingle |
R Ramachandran S Tiwana D Prabhakar K Gowda R Nada V Kumar M Rathi H S Kohli V Jha K L Gupta V Sakhuja Successful induction of granulomatosis with polyangiitis with tacrolimus Indian Journal of Nephrology Antineutrophil cytoplasmic antibodies associated vasculitis granulomatosis with polyangiitis |
author_facet |
R Ramachandran S Tiwana D Prabhakar K Gowda R Nada V Kumar M Rathi H S Kohli V Jha K L Gupta V Sakhuja |
author_sort |
R Ramachandran |
title |
Successful induction of granulomatosis with polyangiitis with tacrolimus |
title_short |
Successful induction of granulomatosis with polyangiitis with tacrolimus |
title_full |
Successful induction of granulomatosis with polyangiitis with tacrolimus |
title_fullStr |
Successful induction of granulomatosis with polyangiitis with tacrolimus |
title_full_unstemmed |
Successful induction of granulomatosis with polyangiitis with tacrolimus |
title_sort |
successful induction of granulomatosis with polyangiitis with tacrolimus |
publisher |
Wolters Kluwer Medknow Publications |
series |
Indian Journal of Nephrology |
issn |
0971-4065 1998-3662 |
publishDate |
2015-01-01 |
description |
We report a 50-year-old female who presented with inflammatory arthritis, upper respiratory tract symptoms, and microscopic hematuria with nephrotic range proteinuria. Antineutrophil cytoplasmic antibodies (ANCA) were detectable and kidney biopsy showed pauci-immune focal necrotizing crescentic glomerulonephritis. She was treated with pulse intravenous cyclophosphamide (CYC) and prednisolone. Patient developed severe leucopenia after the first dose and subsequently had leucopenia to low dose CYC, mycophenolate mofetil and azathioprine were also tried. However, patient developed leukopenia with all the above agents. Initiation of tacrolimus (TAC) was followed by dramatic response: Proteinuria decreased, serum albumin normalized and C-ANCA and anti-PR3 ANCA assays became negative. This is the first successful case of TAC as an induction agent in a patient with GPA (ANCA associated vasculitis with renal involvement). |
topic |
Antineutrophil cytoplasmic antibodies associated vasculitis granulomatosis with polyangiitis |
url |
http://www.indianjnephrol.org/article.asp?issn=0971-4065;year=2015;volume=25;issue=1;spage=46;epage=49;aulast=Ramachandran |
work_keys_str_mv |
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1725569727819939840 |