Case of the Month #25 - ANCA vasculitis

Published 01/02/2022

Key take home messages

  • Around 10% of AKI are intrinsic in nature and easily misdiagnosed.
  • Blood on urine dipstick in AKI in the absence of trauma (catheterisation or UTI) should raise the suspicion of glomerulonephritis and the following screening tests sent
  • ANA
  • DS DNA
  • ANCA
  • Anti GBM
  • Complement
  • Serum Electrophoresis
  • Urine should also be sent for spot urine protein-creatinine ratio

Involve the renal team early in any suspected glomerulonephritis or renal vasculitis as treatment is specialised and early treatment corresponds with less over all morbidity.

  • Pulmonary haemorrhage should raise the suspicion for Anti-GBM disease or ANCA vasculitis amongst other differentials.
  • Treatment requires specialist input and typically involves high dose steroids and cyclophosphamide as immunosuppression.