Would you check ANCA titers in a patient with a history of PR-3-ANCA glomerulonephritis in remission and a stable creatinine but with recurrent microscopic hematuria?
Answer from: at Community Practice
Not sure there is an easy answer to this. A patient in remission should not get a recurrence of glomerular hematuria unless the disease is active. A new onset glomerular hematuria would certainly make me worried about a relapse, some of which may be subtle, indicating "grumbling disease".
The data ...
Absolutely, especially PR3 AAV. I may not act on it alone, but if the PR3 was increasing there is evidence that that (serologic relapse) is a harbinger of clinical relapse. Creatinine climbing is the last thing I would wait to make a decision on. Pr3 AAV is a nasty disease that relapses and I never ...
Comments
at Washington University in St. Louis Thank you Dr. @Rodby.
If you really mean free current hematuria that would indicate that the hematuria is not persistent and certainly you cannot get a recurrence and remission within short periods of time.
Unless the creatinine rises and there is evidence of active disease i.e. proteinuria and hematuria which is persis...
If you have the prior serological history and U/A findings, you will be able to classify this patient if he is in remission or relapse, after ruling out other ethologies for hematuria.
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at Washington University in St. Louis Would you say the clinical presentation for a rela...
at Pacific Nephrology And Internal Medicine Inc You need to rely more on urinary and serological t...