Relapsing polychondritis with glomerulonephritis. Improvement with prednisone and cyclophosphamide
J. L. Ruhlen, K. A. Huston and W. G. Wood
A 32-year-old man presented with relapsing polychondritis (RP) and
microhematuria. A renal biopsy specimen disclosed focal segmental
glomerulonephritis with occasional crescents. Immunofluorescent and
electron micrographic studies suggested immune complex--mediated glomerular
injury. Initially, life-threatening upper airway obstruction responded to
high-dose corticosteroid therapy. Subsequently, progressive renal
insufficiency and proteinuria caused by increasingly active
glomerulonephritis were treated by adding cyclophosphamide, with sustained
improvement. This case supports the concept that RP is an immunologically
mediated disease and suggests that a regimen of prednisone and
cyclophosphamide warrants consideration for use in cases of RP with
glomerulonephritis.