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ANCA-positive IgA nephropathy without necrotising or crescentic glomerulonephritis: a clinical conundrum
  1. Abhilash Koratala1,
  2. Xu Zeng2,
  3. Amir Kazory1
  1. 1Department of Nephrology, University of Florida College of Medicine, Gainesville, Florida, USA
  2. 2Department of NephroPathology, University of Florida College of Medicine, Gainesville, Florida, USA
  1. Correspondence to Dr Abhilash Koratala, akoratsla{at}


IgA nephropathy, the most prevalent form of primary glomerular disease, usually portends a favourable outcome. Antineutrophil cytoplasmic autoantibodies (ANCAs) have been reported in association with IgA nephropathy in a small subset of patients, mostly presenting with rapidly progressive glomerulonephritis and necrotising crescentic lesions. Herein, we describe a case of IgA nephropathy, positive serum cytoplasmic and perinuclear ANCAs with anti-myeloperoxidase antibody, and preserved renal function without any histological evidence of necrotising or crescentic glomerulonephritis. Based on available mechanistic and clinical data, we opine that such patients could benefit from close monitoring of renal function.

  • renal medicine
  • rheumatology
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  • Contributors AbK: attending nephrologist who treated the patient; drafted the initial version of manuscript. XZ: attending pathologist who provided the images and input on pathological findings. AmK: senior nephrologist who provided input on the management decisions; reviewed and revised the manuscript for critically important intellectual content.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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