Chonnam Med J.  2019 May;55(2):124-125. 10.4068/cmj.2019.55.2.124.

Granulomatosis with Polyangiitis Presenting as Cholangitis and Acute Kidney Injury

• Jung JH
• Ahn SH

• KMID: 2447218
• DOI: http://doi.org/10.4068/cmj.2019.55.2.124

Abstract

No abstract available.

MeSH Terms

Acute Kidney Injury*
Cholangitis*
Granulomatosis with Polyangiitis*

Figure

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  FIG. 1 Computed tomography showed only edematous change and central hypo-dense lesion around common bile duct and pancreatic head portion (white arrow) (A), and high resolution computed tomography showed reticular opacity with diffuse ground glass opacity at subpleural portion in both lower lobe and lingular segment of left upper lobe (black arrows) (B). T2-weighted image of magnetic resonance cholangiopancreatography showe distended gallbladder and dilated common bile duct and several tiny renal cysts (black arrows) (C).

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  FIG. 2 The pathologic finding of the kidney demonstrates fibrous crescent and diffuse mesangial proliferation (Periodic Acid Schiff stain, ×400) (white arrow) and markedly increased interstitial inflammation including granulomatous formation (Hematoxylin and Eosin stain, ×100) (black arrow) (A). Follow-up T1-weighted image of magnetic resonance imaging (MRI) showed contrast-enhanced nodular lesion with various sizes on the both kidney (black arrows) (B). Nodular lesion with low signal intensity on T1-weighted MRI and high signal intensity on contrast-enhanced T1-weigthed MRI in the pancreatic head portion around common bile duct was shown (black arrows) (C). Renal artery angiography shows multiple microaneurysms on the interlobular or arcuate arteries without rupture (D).

Reference

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3. Arlet JB, Le Thi Huong D, Marinho A, Cluzel P, Wechsler B, Piette JC. Arterial aneurysms in Wegener's granulomatosis: case report and literature review. Semin Arthritis Rheum. 2008; 37:265–268.