Rapidly Progressive Glomerulonephritis Associated with PR3-ANCA Positive Subacute Bacterial Endocarditis

• DOI: 10.2169/internalmedicine.51.8081
• Publication Date: 2012-09-15T01:02:16Z
• Authors: Hirotaka Fukasawa; Maho Hayashi; Naoko Kinoshita; Sayaka Ishigaki; Shinsuke Isobe; Yukitoshi Sakao; Akihiko Kato; Yoshihide Fujigaki; Ryuichi Furuya
• Keywords: Rapidly progressive glomerulonephritis; Subacute bacterial endocarditis; Proteinase 3; Occult; Rheumatoid factor

Patients with bacterial endocarditis often have renal complications. This report presents the case of an elderly man rapidly progressive glomerulonephritis (RPGN) associated subacute (SBE) due to Enterococcus faecalis infection. The patient was positive for anti-proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) and rheumatoid factor (RF) hypocomplementemia. Treatment SBE antibiotics surgical replacement affected valves resulted in improvement RPGN, disappearance PR3-ANCA RF, normalization rare suggests importance recognizing cause PR3-ANCA, because could be occult RPGN mimicking ANCA-associated vasculitis.