A case of ANCA-associated vasculitis with glomerular eosinophilic infiltration: a possible pathogenic implication

Abstract

We present a 58-year-old male patient with myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis with rapidly progressive glomerulonephritis. He failed to fulfill the common American College of Rheumatology criteria for eosinophilic granulomatosis with polyangiitis and was tentatively diagnosed with microscopic polyangiitis. Kidney biopsy showed pauci-immune crescentic necrotizing glomerulonephritis with neutrophilic and eosinophilic infiltration. Previous reports implicate eosinophils in the pathogenesis of this disease. Therefore, this case suggests that infiltrated eosinophils as well as neutrophils might play roles in the development of tissue injury in systemic vasculitis.

Keywords::

• Myeloperoxidase antineutrophil cytoplasmic antibody (MPO–ANCA)
• Glomerular eosinophilic infiltration
• Eosinophilic granulomatosis with polyangiitis (EGPA)
• Microscopic polyangiitis (MPA)
• Pauci-immune crescentic necrotizing glomerulonephritis