• Internal medicine · Jun 2024

    Case Reports

    Renal Medullary Angiitis Associated with Cutaneous Leukocytoclastic Vasculitis: A Case Report.

    • Shoko Miura, Kan Katayama, Kensuke Joh, Mika Fujimoto, Mayuko Yamakawa, Enyo Akiyama, Junji Nishida, Masashi Yasutomi, Eiji Ishikawa, and Kaoru Dohi.
    • Department of Nephrology, Kuwana City Medical Center, Japan.
    • Intern. Med. 2024 Jun 15; 63 (12): 175717631757-1763.

    AbstractRenal medullary angiitis is characterized by interstitial hemorrhaging in the medulla with neutrophil infiltration. An 81-year-old man presented with a fever, kidney dysfunction, and purpura of the legs, which was diagnosed as leukocytoclastic vasculitis. Proteinase 3 antineutrophil cytoplasmic antibodies were weakly positive. A kidney biopsy showed severe tubulointerstitial hemorrhaging with neutrophilic infiltration in the perivascular areas surrounding the vasa recta in the medulla without crescent formation in the glomeruli. An immunofluorescence analysis was negative, and electron microscopy revealed no immune-dense deposits, ruling out immunoglobulin A vasculitis. Intravenous methylprednisolone for three days and plasma exchange followed by oral prednisolone improved his general condition.

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