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Biopsy of Kidneys and Lungs Performed for Diagnosis

For a larger image, please click on Edema 10  

Above: Cellular crescent.

Below: Paucity of immune complex deposits ("Pauci-immune").

 

For a larger image, please click on Edema 11

 

 Kidney Biopsy Findings

 1. Pauci-immune focal necrotizing and crescentic glomerulonephritis, consistent with ANCA-associated glomerulonephritis

Lung Findings

Below: on left, infarct/necrosis and on the lower right, hemorrhage.

For a larger image, please click on Edema 12

Below: image showing venulitis (pink areas).

For larger images, please click on Edema 13  and Edema 14  
 

Lung Biopsy Findings

1. Acute parenchymal hemorrhage

2. Polyangiitis - Granulomas

Diagnosis

Granulomatosis with Polyangiitis (GPA)

GPA Clinical Manifestations

  • Constitutional symptoms
  • ENT
    • Rhinosinusitis, hearing loss, cartilaginous
  • Pulmonary
    • Nodules, pulmonary hemorrhage
  • Renal
    • Asymptomatic hematuria --> rapidly progressive glomerulonephritis
  • Musculoskeletal
  • Skin
    • Leukocytoclastic angiitis
  • Neurological
    • Mononeuritis multiplex
  • Ophthalmological
    • Scleritis, retro-orbital pseudotumor

 

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