Abstract:

A 66 year old woman underwent long-term anticoagulation therapy with warfarin due to bioprosthetic heart valve replacement. The renal involvement was noticed 4 months ago, manifesting persistent microscopic hematuria and paroxysmal gross hematuria with simultaneously serum creatinine increasing, in the case of excessive anticoagulation. Blood examination found positive MPOANCA and renal biopsy conformed the renal damage of ANCA associated vasculitis, combined with IgA nephropathy. Gross hematuria dissovled after anticoagulant withdrawal and renal function recovered spontaneously. So warfarin associated nephropathy was also considered.