Bilateral Ureteral Stenosis with Hydronephrosis as First Manifestation of Granulomatosis with Polyangiitis (Wegener’s Granulomatosis): A Case Report and Review of the Literature

Ureteral stenosis is a rare manifestation of granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis). We report the case of a 76-year-old woman with progressive renal failure in which bilateral hydronephrosis due to ureteral stenosis was the first manifestation of the disease....

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Main Authors: Joelle Suillot, Jürg Bollmann, Samuel Rotman, Eric Descombes
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Nephrology
Online Access:http://dx.doi.org/10.1155/2020/7189497
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author Joelle Suillot
Jürg Bollmann
Samuel Rotman
Eric Descombes
author_facet Joelle Suillot
Jürg Bollmann
Samuel Rotman
Eric Descombes
author_sort Joelle Suillot
collection DOAJ
description Ureteral stenosis is a rare manifestation of granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis). We report the case of a 76-year-old woman with progressive renal failure in which bilateral hydronephrosis due to ureteral stenosis was the first manifestation of the disease. Our patient also had renal involvement with pauci-immune crescentic glomerulonephritis associated with high titers of anti-proteinase 3 c-ANCAs, but no involvement of the upper or lower respiratory tract. The hydronephrosis and renal function rapidly improved under immunosuppressive therapy with high-dose corticosteroids and intravenous pulse cyclophosphamide. We reviewed the literature and found only ten other reported cases of granulomatosis with polyangiitis/Wegener’s granulomatosis and intrinsic ureteral stenosis: in two cases, the presenting clinical manifestation was unilateral hydronephrosis and in only two others was the hydronephrosis bilateral, but this complication developed during a relapse of the disease. This case emphasizes the importance of including ANCA-related vasculitis in the differential diagnosis of unusual cases of unilateral or bilateral ureteral stenosis.
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publishDate 2020-01-01
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series Case Reports in Nephrology
spelling doaj-art-797961a993af41e3a6aafd3facc5dffe2025-02-03T01:00:12ZengWileyCase Reports in Nephrology2090-66412090-665X2020-01-01202010.1155/2020/71894977189497Bilateral Ureteral Stenosis with Hydronephrosis as First Manifestation of Granulomatosis with Polyangiitis (Wegener’s Granulomatosis): A Case Report and Review of the LiteratureJoelle Suillot0Jürg Bollmann1Samuel Rotman2Eric Descombes3Service of Nephrology, HFR Cantonal Hospital Fribourg, Fribourg, SwitzerlandService of Urology, HFR Cantonal Hospital Fribourg, Fribourg, SwitzerlandService of Clinical Pathology, Lausanne University Hospital, University of Lausanne, Lausanne, SwitzerlandService of Nephrology, HFR Cantonal Hospital Fribourg, Fribourg, SwitzerlandUreteral stenosis is a rare manifestation of granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis). We report the case of a 76-year-old woman with progressive renal failure in which bilateral hydronephrosis due to ureteral stenosis was the first manifestation of the disease. Our patient also had renal involvement with pauci-immune crescentic glomerulonephritis associated with high titers of anti-proteinase 3 c-ANCAs, but no involvement of the upper or lower respiratory tract. The hydronephrosis and renal function rapidly improved under immunosuppressive therapy with high-dose corticosteroids and intravenous pulse cyclophosphamide. We reviewed the literature and found only ten other reported cases of granulomatosis with polyangiitis/Wegener’s granulomatosis and intrinsic ureteral stenosis: in two cases, the presenting clinical manifestation was unilateral hydronephrosis and in only two others was the hydronephrosis bilateral, but this complication developed during a relapse of the disease. This case emphasizes the importance of including ANCA-related vasculitis in the differential diagnosis of unusual cases of unilateral or bilateral ureteral stenosis.http://dx.doi.org/10.1155/2020/7189497
spellingShingle Joelle Suillot
Jürg Bollmann
Samuel Rotman
Eric Descombes
Bilateral Ureteral Stenosis with Hydronephrosis as First Manifestation of Granulomatosis with Polyangiitis (Wegener’s Granulomatosis): A Case Report and Review of the Literature
Case Reports in Nephrology
title Bilateral Ureteral Stenosis with Hydronephrosis as First Manifestation of Granulomatosis with Polyangiitis (Wegener’s Granulomatosis): A Case Report and Review of the Literature
title_full Bilateral Ureteral Stenosis with Hydronephrosis as First Manifestation of Granulomatosis with Polyangiitis (Wegener’s Granulomatosis): A Case Report and Review of the Literature
title_fullStr Bilateral Ureteral Stenosis with Hydronephrosis as First Manifestation of Granulomatosis with Polyangiitis (Wegener’s Granulomatosis): A Case Report and Review of the Literature
title_full_unstemmed Bilateral Ureteral Stenosis with Hydronephrosis as First Manifestation of Granulomatosis with Polyangiitis (Wegener’s Granulomatosis): A Case Report and Review of the Literature
title_short Bilateral Ureteral Stenosis with Hydronephrosis as First Manifestation of Granulomatosis with Polyangiitis (Wegener’s Granulomatosis): A Case Report and Review of the Literature
title_sort bilateral ureteral stenosis with hydronephrosis as first manifestation of granulomatosis with polyangiitis wegener s granulomatosis a case report and review of the literature
url http://dx.doi.org/10.1155/2020/7189497
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