ANCA ASSOCIATED VASCULITIS-ALLERGICA-CUTIS (VAC) AND MILD PROLIFERATIVE NECROTIZING GLOMERULONEPHRITIS

We report here the case of a 69-year-old male with vasculitis allergic a cutis (VAC) accompanied by a nephrotic syndrome associated with seru m perinuclear-staining anti-neutrophil cytoplasmic antibody (P-ANCA). Renal biopsy specimens showed mild proliferative glomerulonephritis wi th crescentic and necrotizing lesion in the glomeruli, while lesional skin biopsy specimens showed leukocytoclastic vasculitis in the deep d ermis. Pauci-immune deposits were evident (deposits of immunoglobulins and complements were absent) by immunofluorescence microscopy in both tissues. The appearance of weakly positive P-ANCA associated with ski n lesions and renal dysfunction occurred twice in this patient. Follow ing corticosteroid administration, renal dysfunction was remarkably di minished and proteinuria decreased. P-ANCA titer were decreased, reach ing the normal level. ANCA associated glomerulonephritis complicated b y VAC has not been reported previously. In the present case, the vascu litis cutis and glomerulonephritis is assumed to be associated with th e appearance of weakly positive P-ANCA.