Wegener's granulomatosis presenting as acute suppurative interstitial nephritis

Abstract

A 78 year old man presented with acute renal failure following a prolonged respiratory illness.A renal biopsy demonstrated severe suppurative interstitial nephritis with normal glomeruli.After nine weeks of antibiotics he remained anuric and a second biopsy demonstrated pauci-immune, necrotising glomerulonephritis.His subsequent clinical course was consistent with a diagnosis of Wegener's granulomatosis and antineutrophil cytoplasmic antibodies (ANCA) were detected.This is the first reported case of Wegener's granulomatosis presenting with an isolated tubulointerstitial lesion.