Granulomatosis with Polyangiitis Presenting as a Renal Mass: A Scarce Case Report with a Review of the Literature
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Date
2023-01
Journal Title
Journal ISSN
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Publisher
Thieme Medical and Scientific Publishers Pvt. Ltd
Abstract
Wegener granulomatosis (WG) now known as granulomatosis with polyangiitis (GPA) is an uncommon autoimmune disorder of undivulged etiology affecting the respiratory tract including paranasal sinuses, nasal cavity, lungs, and kidneys predominantly. GPA presenting as a solitary renal mass is rarely seen. We present a case report of a 27-year-old female presenting with a right renal mass along with pain, low-grade fever, and arthralgia. Computed tomography scan of the abdomen revealed a hypodense low attenuated renal mass with indistinct margins. Ultrasound-guided biopsy revealed features typical of GPA. She was started on oral steroids (prednisolone 40?mg) and azathioprine. She developed pain, vomiting, and diarrhea after starting treatment with azathioprine. Azathioprine was stopped and rituximab 1?g weekly was started for 4 weeks followed by 500?mg 6 monthly injections. She got symptomatic relief at 4 weeks with a diminution of renal mass at 6 months follow-up. We report this rare entity of WG presenting as renal mass. Suspecting and diagnosing renal mass as a part of GPA prevented us from undertaking unnecessary surgical treatment in this patient. Medical treatment with steroids and rituximab is effective in inducing remission and maintenance.
Description
Keywords
Wegener granulomatosis, granulomatosis with polyangiitis, immunosuppressive therapy
Citation
Kumar, Manjeet
Barwal, Kailash Chander
Sharma, Sunish
Chauhan, Sanjeev
Raina, Pamposh. Granulomatosis with Polyangiitis Presenting as a Renal Mass: A Scarce Case Report with a Review of the Literature. Annals of the National Academy of Medical Sciences. 2023 Jan; 59(1): 55-59
Barwal, Kailash Chander
Sharma, Sunish
Chauhan, Sanjeev
Raina, Pamposh. Granulomatosis with Polyangiitis Presenting as a Renal Mass: A Scarce Case Report with a Review of the Literature. Annals of the National Academy of Medical Sciences. 2023 Jan; 59(1): 55-59