Acute kidney injury and ANCA positivity in a patient treated with glecaprevir/pibrentasvir: a case report
BackgroundGlecaprevir/pibrentasvir is an effective antiviral therapy for hepatitis C virus infection and is generally regarded safe in patients with renal impairment. However, renal complications are a notable, albeit rare, concern.Case presentationWe report a case of acute kidney injury in a man in...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2024.1434497/full |
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| author | Lawrence Hyun Kwon Jennifer Griffiths Lanny DiFranza |
| author_facet | Lawrence Hyun Kwon Jennifer Griffiths Lanny DiFranza |
| author_sort | Lawrence Hyun Kwon |
| collection | DOAJ |
| description | BackgroundGlecaprevir/pibrentasvir is an effective antiviral therapy for hepatitis C virus infection and is generally regarded safe in patients with renal impairment. However, renal complications are a notable, albeit rare, concern.Case presentationWe report a case of acute kidney injury in a man in his 50s with chronic hepatitis C virus, chronic obstructive pulmonary disease, morbid obesity, a history of heroin dependence, and untreated type 2 diabetes mellitus. About four weeks into an eight-week glecaprevir/pibrentasvir regimen he developed progressive lower extremity edema, bullae, and skin ulcers with worsening renal function. His serum creatinine rose to 4.46 mg/dL and blood urea nitrogen to 44 mg/dL. ANCA serology revealed dual perinuclear and cytoplasmic positivity, though anti-proteinase 3 and anti-myeloperoxidase antibody tests were negative. Kidney biopsy revealed diffuse tubulointerstitial injury with erythrocyte casts indicative of glomerular bleeding into the distal nephrons, though without glomerular crescent formation.ConclusionThis case illustrates the potential for glecaprevir/pibrentasvir to induce acute kidney injury, acute interstitial nephritis and possibly ANCA-associated vasculitis. Recognizing these adverse renal effects is critical for making timely diagnosis and management in hepatitis C virus patients undergoing antiviral therapy. |
| format | Article |
| id | doaj-art-c6d8122753004a11949fd782f879d039 |
| institution | Kabale University |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj-art-c6d8122753004a11949fd782f879d0392025-01-15T04:11:02ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-01-011110.3389/fmed.2024.14344971434497Acute kidney injury and ANCA positivity in a patient treated with glecaprevir/pibrentasvir: a case reportLawrence Hyun Kwon0Jennifer Griffiths1Lanny DiFranza2Department of Nephrology, Westchester Medical Center Advanced Physician Services, Mid-Hudson Regional Hospital, Poughkeepsie, NY, United StatesDepartment of Nephrology, Westchester Medical Center Advanced Physician Services, Mid-Hudson Regional Hospital, Poughkeepsie, NY, United StatesDepartment of Pathology, Montefiore Medical Center, Bronx, NY, United StatesBackgroundGlecaprevir/pibrentasvir is an effective antiviral therapy for hepatitis C virus infection and is generally regarded safe in patients with renal impairment. However, renal complications are a notable, albeit rare, concern.Case presentationWe report a case of acute kidney injury in a man in his 50s with chronic hepatitis C virus, chronic obstructive pulmonary disease, morbid obesity, a history of heroin dependence, and untreated type 2 diabetes mellitus. About four weeks into an eight-week glecaprevir/pibrentasvir regimen he developed progressive lower extremity edema, bullae, and skin ulcers with worsening renal function. His serum creatinine rose to 4.46 mg/dL and blood urea nitrogen to 44 mg/dL. ANCA serology revealed dual perinuclear and cytoplasmic positivity, though anti-proteinase 3 and anti-myeloperoxidase antibody tests were negative. Kidney biopsy revealed diffuse tubulointerstitial injury with erythrocyte casts indicative of glomerular bleeding into the distal nephrons, though without glomerular crescent formation.ConclusionThis case illustrates the potential for glecaprevir/pibrentasvir to induce acute kidney injury, acute interstitial nephritis and possibly ANCA-associated vasculitis. Recognizing these adverse renal effects is critical for making timely diagnosis and management in hepatitis C virus patients undergoing antiviral therapy.https://www.frontiersin.org/articles/10.3389/fmed.2024.1434497/fullacute kidney injuryANCA-associated vasculitisacute tubulointerstitial nephritisglecaprevir/pibrentasvirdrug-induced nephrotoxicityhepatitis C virus treatment |
| spellingShingle | Lawrence Hyun Kwon Jennifer Griffiths Lanny DiFranza Acute kidney injury and ANCA positivity in a patient treated with glecaprevir/pibrentasvir: a case report Frontiers in Medicine acute kidney injury ANCA-associated vasculitis acute tubulointerstitial nephritis glecaprevir/pibrentasvir drug-induced nephrotoxicity hepatitis C virus treatment |
| title | Acute kidney injury and ANCA positivity in a patient treated with glecaprevir/pibrentasvir: a case report |
| title_full | Acute kidney injury and ANCA positivity in a patient treated with glecaprevir/pibrentasvir: a case report |
| title_fullStr | Acute kidney injury and ANCA positivity in a patient treated with glecaprevir/pibrentasvir: a case report |
| title_full_unstemmed | Acute kidney injury and ANCA positivity in a patient treated with glecaprevir/pibrentasvir: a case report |
| title_short | Acute kidney injury and ANCA positivity in a patient treated with glecaprevir/pibrentasvir: a case report |
| title_sort | acute kidney injury and anca positivity in a patient treated with glecaprevir pibrentasvir a case report |
| topic | acute kidney injury ANCA-associated vasculitis acute tubulointerstitial nephritis glecaprevir/pibrentasvir drug-induced nephrotoxicity hepatitis C virus treatment |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2024.1434497/full |
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