PMID- 38473038
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240315
IS  - 2075-4418 (Print)
IS  - 2075-4418 (Electronic)
IS  - 2075-4418 (Linking)
VI  - 14
IP  - 5
DP  - 2024 Mar 6
TI  - Cutting-Edge Strategies for Renal Tumour-like Lesions in Granulomatosis with 
      Polyangiitis: A Systematic Review.
LID - 10.3390/diagnostics14050566 [doi]
LID - 566
AB  - BACKGROUND: Granulomatosis with polyangiitis (GPA) is characterised by 
      granulomatous inflammation and small-to-medium vessel necrotising vasculitis, 
      mainly affecting respiratory tract and kidneys. Renal involvement presenting as 
      tumour-like lesions poses diagnostic and treatment challenges. METHODS: Following 
      the observation of a GPA patient presenting with multiple renal tumour-like 
      lesions, we conducted a systematic literature review on MEDLINE/PubMed, EMBASE, 
      and Cochrane databases. Data gathered from the literature were analysed to 
      summarise the diagnostic approach, management, and outcome of renal GPA-related 
      tumour-like lesions. RESULTS: a 49-year-old female presented with persistent 
      constitutional symptoms and multiple bilateral renal lesions. Renal biopsy showed 
      chronic interstitial inflammation with necrotising granulomas. Laboratory tests 
      disclosed positive anti-proteinase 3 (PR3) anti-neutrophil cytoplasmic antibody 
      (ANCA) leading to a final diagnosis of GPA. She was effectively treated with 
      high-dose glucocorticoids and rituximab. Literature search yielded 41 articles, 
      concerning 42 GPA patients with renal masses, presenting bilaterally in 23.8% of 
      the cases. Positive PR3-ANCA was observed in 86.5% of the cases. Half of 42 
      patients showed kidney abnormalities. Treatment with glucocorticoids (83.3%) and 
      immunosuppressive agents (80.9%) resulted in an overall good remission rate and 
      favourable prognosis. CONCLUSIONS: GPA should be considered in the differential 
      diagnoses of kidney tumour-like lesions. The diagnosis is challenging, and 
      histological examination greatly contributes to the diagnostic work-up.
FAU - Iorio, Luca
AU  - Iorio L
AD  - Rheumatology Unit, Department of Medicine DIMED, University of Padua, 35121 
      Padua, Italy.
FAU - Pizzi, Marco
AU  - Pizzi M
AUID- ORCID: 0000-0003-4006-7317
AD  - Surgical Pathology and Cytopathology Unit, Department of Medicine DIMED, 
      University of Padua, 35121 Padua, Italy.
FAU - Cecchin, Diego
AU  - Cecchin D
AUID- ORCID: 0000-0001-7956-1924
AD  - Nuclear Medicine Unit, Department of Medicine DIMED, University of Padua, 35121 
      Padua, Italy.
FAU - Davanzo, Federica
AU  - Davanzo F
AD  - Rheumatology Unit, Department of Medicine DIMED, University of Padua, 35121 
      Padua, Italy.
FAU - Ghirardello, Anna
AU  - Ghirardello A
AD  - Rheumatology Unit, Department of Medicine DIMED, University of Padua, 35121 
      Padua, Italy.
FAU - Dei Tos, Angelo Paolo
AU  - Dei Tos AP
AD  - Surgical Pathology and Cytopathology Unit, Department of Medicine DIMED, 
      University of Padua, 35121 Padua, Italy.
FAU - Doria, Andrea
AU  - Doria A
AUID- ORCID: 0000-0003-0548-4983
AD  - Rheumatology Unit, Department of Medicine DIMED, University of Padua, 35121 
      Padua, Italy.
FAU - Padoan, Roberto
AU  - Padoan R
AUID- ORCID: 0000-0002-2356-375X
AD  - Rheumatology Unit, Department of Medicine DIMED, University of Padua, 35121 
      Padua, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20240306
PL  - Switzerland
TA  - Diagnostics (Basel)
JT  - Diagnostics (Basel, Switzerland)
JID - 101658402
PMC - PMC10930867
OTO - NOTNLM
OT  - ANCA vasculitis
OT  - Wegener granulomatosis
OT  - granuloma
OT  - granulomatosis with polyangiitis
OT  - pseudotumour
OT  - renal masses
OT  - renal tumour-like lesions
COIS- The authors declare no financial support or potential conflicts of interest in 
      this study.
EDAT- 2024/03/13 06:47
MHDA- 2024/03/13 06:48
PMCR- 2024/03/06
CRDT- 2024/03/13 01:17
PHST- 2024/02/06 00:00 [received]
PHST- 2024/03/03 00:00 [revised]
PHST- 2024/03/04 00:00 [accepted]
PHST- 2024/03/13 06:48 [medline]
PHST- 2024/03/13 06:47 [pubmed]
PHST- 2024/03/13 01:17 [entrez]
PHST- 2024/03/06 00:00 [pmc-release]
AID - diagnostics14050566 [pii]
AID - diagnostics-14-00566 [pii]
AID - 10.3390/diagnostics14050566 [doi]
PST - epublish
SO  - Diagnostics (Basel). 2024 Mar 6;14(5):566. doi: 10.3390/diagnostics14050566.