[A case of ANCA-associated XXXX without extrarenal symptoms with disease flare after starting dialysis].

@entity1 @entity3335 @entity66 @entity500 @entity417 @entity101 @entity786 @entity1295 @entity1458 @entity1988 @entity1726 @entity631 @entity617 @entity454
A Japanese @entity1 aged 13 years with @entity3335 anti-neutrophil cytoplasmic antibodies(MPO-ANCA)-associated @entity631 (GN) progressed to @entity454 after 7 years' clinical observation. She had been suffering from @entity66 flare associated with serum MPO-ANCA elevation(i.e. 153 EU/ml, 208 EU/ml and 358 EU/ml, maximum at each of the episodes, normal < 10 EU/ml). Each flare was treated successfully with @entity617 combined with @entity786 and @entity500 . However, her renal function gradually deteriorated, and peritoneal dialysis( @entity1726 ) was initiated 7 years after the onset of the disease. During the clinical course, no extrarenal manifestations were observed. Due to subsidence of the serum MPO-ANCA titer(10 EU/ml) after starting @entity1726 , @entity617 and @entity500 were tapered thereafter. Her daily urine volume was preserved at approximately 600 ml at that time. She suddenly developed @entity1295 with severe @entity417 , @entity1458 and @entity101 4 months after discontinuation of immunosuppressive therapy. The serum titer of MPO-ANCA increased to 100 EU/ml. These clinical observation suggests that disease flare may occur in selected @entity1 with MPO-ANCA-associated GN, who develop @entity454 requiring @entity1726 . Although recurrent flare associated with an increased serological activity in a proportion of @entity1 with @entity1988 who have received dialysis has been reported to date, to our knowledge, a similar clinical observation in the MPO-ANCA-associated GN has not been reported. Selected @entity1 with the disease should be followed with close observation after undergoing dialysis.
