69-Year-Old Man With Nasal Congestion and Pre-Syncope
May 2021
in “
Mayo Clinic Proceedings
”
TLDR A 69-year-old man with sinus infection and fainting spells was diagnosed with a rare kidney disease, treated with steroids and a specific drug, which improved his condition.
A 69-year-old man with benign prostatic hyperplasia experienced pre-syncopal episodes and a sinus infection for over a month. His condition worsened over three weeks, with increased proteinuria and decreased hemoglobin. A renal biopsy confirmed a diagnosis of microscopic polyangiitis, a type of ANCA-associated vasculitis. The patient was treated with glucocorticoids and rituximab, which resolved his symptoms after three months. The document highlights the importance of urinalysis in differentiating causes of Acute Kidney Injury (AKI) in older adults, and the need for suspicion of other organ involvement in ANCA-associated vasculitis. It also emphasizes that Rapidly Progressive Glomerulonephritis (RPGN) should be suspected in patients with certain symptoms, and that the diagnosis of ANCA-associated vasculitis is established through biopsy, but treatment can be initiated in severely ill patients.
