Atypical Wegener's Granulomatosis with Positive Cytoplasmic Antineutrophil Cytoplasmic Antibodies, Ophthalmologic Manifestations, and Slowly Progressive Renal Failure without Respiratory Tract Involvement

Tomoko KAKIZAWA; Kazuo ICHIKAWA; Keishi YAMAUCHI; Teiji TAKEDA; Minoru NAGAI; Jun-ichiro MORI; Wataru YUMITA; Takahide MIYAMOTO; Takeshi NAGASAWA; Kiyoshi HASHIZUME

doi:10.2169/internalmedicine.38.679

Tomoko KAKIZAWA, Kazuo ICHIKAWA, Keishi YAMAUCHI, Teiji TAKEDA, Minoru NAGAI, Jun-ichiro MORI, Wataru YUMITA, Takahide MIYAMOTO, Takeshi NAGASAWA, Kiyoshi HASHIZUME

Author information

Tomoko KAKIZAWA
The Department of Geriatrics, Shinshu University School of Medicine
Kazuo ICHIKAWA
The Department of Geriatrics, Shinshu University School of Medicine
Keishi YAMAUCHI
The Department of Geriatrics, Shinshu University School of Medicine
Teiji TAKEDA
The Department of Geriatrics, Shinshu University School of Medicine
Minoru NAGAI
The Department of Geriatrics, Shinshu University School of Medicine
Jun-ichiro MORI
The Department of Geriatrics, Shinshu University School of Medicine
Wataru YUMITA
The Department of Geriatrics, Shinshu University School of Medicine
Takahide MIYAMOTO
The Department of Geriatrics, Shinshu University School of Medicine
Takeshi NAGASAWA
The Department of Geriatrics, Shinshu University School of Medicine
Kiyoshi HASHIZUME
The Department of Geriatrics, Shinshu University School of Medicine

Keywords: nephrotic syndrome, retinal embolism, immunosuppressive therapy

JOURNAL FREE ACCESS

1999 Volume 38 Issue 8 Pages 679-682

DOI https://doi.org/10.2169/internalmedicine.38.679

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Abstract

A 68-year-old woman had microscopic hematuria and proteinuria since the age of 50. She also had hearing impairment, arthralgia, retinal embolism, peripheral arterial occlusion of the right foot and chronic renal failure during the course. At the age of 68, she had progressive renal failure and nephrotic syndrome with high titers of serum cytoplasmic antineutrophil Cytoplasmic antibodies (c-ANCA). No evidence of respiratory tract involvement was found. Methylprednisolone pulse therapy and low dose cyclophosphamide therapy ameliorated the renal failure and reduced the serum c-ANCA level. She, however, died on July 19, 1998 due to pulmonary fungal and pneumocystis carinii infection.
(Internal Medicine 38: 679-682, 1999)

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