The renal manifestations of granulomatosis with polyangiitis (GPA) are occult on imaging, especially when compared to the pulmonary changes.
For a general discussion of the condition, please refer to the main article on granulomatosis with polyangiitis (GPA). For other organ-specific radiographic features, please refer to individual articles:
Granulomatosis with polyangiitis (previously known as Wegener granulomatosis), is a multi-system systemic necrotizing non-caseating granulomatous vasculitis affecting small to medium-sized arteries, capillaries and veins.
On this page:
Epidemiology
Approximately half of GPA patients have kidney disease at presentation.
Three patterns of appearance4.
solitary-type (62%, 13/21)
multiple bilateral masses (28.5%, 6/21)
multiple unilateral masses (9.5%, 2/21)
Clinical presentation
Reduced renal function, proteinuria and hematuria.
Pathology
GPA affects the kidneys with the development of necrotizing glomerulonephritis in ~60% (range 39-80%) of patients.
CT
Contrast-enhanced CT findings4.
hypovascular mass (100%, 15/15)
unclear margins ( 93%, 14/15)
opacity of peri-renal fat ( 20%, 3/15)
enlargement of the para-aortic lymph nodes (7%, 1/15)
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