Antineutrophil cytoplasmic autoantibodies with myeloperoxidase specificity in a patient with anti-glomerular basement membrane disease.

An unusual case is described of a patient with both anti-glomerular basement membrane (GBM) disease and anti-neutrophil cytoplasmic autoantibodies with myeloperoxidase specificity (MPO-ANCA) presenting with acute renal failure. Four years before a seronegative arthritis of the left wrist was diagnosed. Tests for ANCA by indirect immunofluorescence were repeatedly negative. The diagnosis was made by renal biopsy and by testing the serum with specific enzyme-linked immunosorbent assays (ELISA) for MPO-ANCA and anti-GBM antibodies. To our knowledge, this is the first patient presenting with such findings in the Dutch literature.

[Tubulointerstitial nephritis caused by mesalazine (5-ASA) agents]. / Tubulo-interstitiële nefritis door mesalazine (5-ASA)-preparaten.

In five patients (4 men aged 34, 20, 22 and 29 years, and a woman of 34 years) tubulo-interstitial nephritis developed during treatment with 5-aminosalicylic acid (5-ASA) containing drugs for colitis ulcerosa, proctocolitis or Crohn's disease. Two patients had an impaired renal function before treatment with 5-ASA medication. In all patients there was only an incomplete recovery of renal function after cessation of the therapy. It is therefore necessary to monitor renal function regularly in patients receiving 5-ASA containing preparations.

A sporadic case of acute Hantavirus nephropathy in The Netherlands.

A 32-yr-old man presented with acute renal failure preceded by a viral-like disease with high fever, bilateral loin pain, nausea, headache and slight thrombocytopenia. Renal biopsy revealed only minor tubulointerstitial abnormalities. Renal function completely normalised within 10 days after hospitalisation. The diagnosis of acute Hantavirus nephropathy was proved by serological examinations.