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An 11-year-old girl with antineutrophil cytoplasmic antibody-associated glomerulonephritis identified by a school urinary screening program

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Abstract

Antineutrophil cytoplasmic autoantibody-associated glomerulonephritis (GN) in childhood is rare and has a poor prognosis. We report an 11-year-old girl with renal-limited antineutrophil cytoplasmic autoantibody-associated vasculitis. Proteinuria and hematuria were first detected by a school urinary screening (SUS) program. Histopathological examination revealed pauci-immune necrotizing GN. She did not display purpura or peripheral neuropathy. She was diagnosed with antineutrophil cytoplasmic autoantibody-associated GN based on proteinuria, high serum titers of antineutrophil cytoplasmic autoantibodies (ANCAs), and pauci-immune necrotizing GN. The patient was treated with combination therapy, consisting of methylprednisolone and urokinase pulse, prednisolone, mizoribine (MZB), warfarin, and dilazep hydrochloride. At 2 months after treatment, urinary protein excretion was decreased and the hematuria had disappeared, while the serum titer of ANCAs was also decreased. The dose of prednisolone was tapered, and proteinuria and hematuria later disappeared at 9 months after treatment. In conclusion, we reported an 11-year-old girl with renal-limited antineutrophil cytoplasmic autoantibody-associated vasculitis early identified by a SUS program and treated with multi-drug combination therapy including MZB. On the basis of our results, we believe that a SUS programs may be effective for the early identification and treatment of children with renal-limited antineutrophil cytoplasmic autoantibody-associated vasculitis.

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Conflict of interest

We have no conflicting interests affecting the present study.

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Informed consent was obtained from all patients or their parents.

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Authors and Affiliations

  1. Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan

    Shuto Kanno, Yukihiko Kawasaki, Ryo Maeda, Kyohei Miyazaki, Atsushi Ono, Yuichi Suzuki, Kazuhide Suyama, Shigeo Suzuki & Mitsuaki Hosoya

Authors
  1. Shuto Kanno
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  2. Yukihiko Kawasaki
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  3. Ryo Maeda
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  4. Kyohei Miyazaki
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  5. Atsushi Ono
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  6. Yuichi Suzuki
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  7. Kazuhide Suyama
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  8. Shigeo Suzuki
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  9. Mitsuaki Hosoya
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Corresponding author

Correspondence to Yukihiko Kawasaki.

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Kanno, S., Kawasaki, Y., Maeda, R. et al. An 11-year-old girl with antineutrophil cytoplasmic antibody-associated glomerulonephritis identified by a school urinary screening program. CEN Case Rep 3, 232–236 (2014). https://doi.org/10.1007/s13730-014-0126-1

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  • DOI: https://doi.org/10.1007/s13730-014-0126-1

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