Document Detail

A case of microscopic polyangiitis relapsed with diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis
MedLine Citation:
PMID:  19564716     Owner:  NLM     Status:  MEDLINE    
The patient was a 63-year-old woman. She was admitted to our hospital with acute renal failure and multiple mononeuritis in 2002. She was diagnosed as microscopic polyangiitis based on positive for MPO-ANCA. Remission was induced by combination therapy with methylprednisolone pulse therapy and plasma exchange. Because condition of the disease was stable, prednisolone was discontinued from August 2006. Elevation of serum creatinine and microscopic hematuria was detected in November 2007. Fever and dyspnea occurred in January 24 2008. Elevation of CRP and serum creatinine was found, and infiltration in bilateral lung was noted on chest X-ray. She was admitted on the same day. After admission, she presented with hemosputum and exacerbation of dyspnea. Chest CT revealed diffuse consolidation and ground glass opacity, and MPO-ANCA converted to be positive. Diagnosis of diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis with microscopic polyangiitis was made, and she was managed by artificial respirator and CHDF in ICU. Combination therapy with steroid pulse therapy and plasma exchange re-induced remission. Mizoribine was administrated as maintenance therapy with oral prednisolone.
Shinya Kawashiri; Atsushi Kawakami; Naoki Iwamoto; Keita Fujikawa; Toshiyuki Aramaki; Kunihiro Ichinose; Makoto Kamachi; Mami Tamai; Kazuhiko Arima; Hideki Nakamura; Masako Kita; Hiroaki Ida; Tomoki Origuchi; Katsumi Eguchi
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Publication Detail:
Type:  Case Reports; English Abstract; Journal Article    
Journal Detail:
Title:  Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology     Volume:  32     ISSN:  1349-7413     ISO Abbreviation:  Nihon Rinsho Meneki Gakkai Kaishi     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-30     Completed Date:  2009-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505992     Medline TA:  Nihon Rinsho Meneki Gakkai Kaishi     Country:  Japan    
Other Details:
Languages:  jpn     Pagination:  189-94     Citation Subset:  IM    
Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University.
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MeSH Terms
Glomerulonephritis / complications*
Hemorrhage / complications*
Lung Diseases / complications*
Middle Aged
Pulmonary Alveoli
Vasculitis / complications*,  therapy

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