Skip to main content

Advertisement

SpringerLink
Log in

A case of myeloperoxidase–antineutrophil cytoplasmic antibody positive-polyarteritis nodosa complicated by interstitial pneumonia and rapidly progressive renal failure

  • Case report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

A 73-year-old woman was admitted to our hospital because of persistent high fever and cough, generalized myalgia, and renal dysfunction. Laboratory examination revealed severe inflammatory signs, pulmonary fibrosis, progression of renal impairment with active nephritic urinary sediments, and a high titer of myeloperoxidase–antineutrophil cytoplasmic antibody, indicating that she might have microscopic polyangiitis with interstitial pneumonia and rapidly progressive glomerulonephritis. Her renal biopsy, however, showed tubulointerstitial changes with mild glomerular abnormalities, and renal angiography revealed that she had vascular lesions of medium-sized arteries, which were compatible with classical polyarteritis nodosa. Tissue biopsy of the clinically affected organ should be considered in anyone suspected to have vasculitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Jennette C, Falk RJ (1997) Small-vessel vasculitis. N Engl J Med 337:1512–1523

    Article  PubMed  CAS  Google Scholar 

  2. Weyand CM, Goronzy JJ (2003) Medium- and large-vessel vasculitis. N Engl J Med 349:160–169

    Article  PubMed  CAS  Google Scholar 

  3. Savage COS, Harper L, Cockwell P, Adu D, Howie A (2000) ABC of arterial and vascular disease: vasculitis. BMJ 320:1325–1328

    Article  PubMed  CAS  Google Scholar 

  4. Gutierrez E (2004) Microscopic polyangiitis. In: Latinis KM, Dao K, Gutierrez E, Shepherd R, Velazquez CR (eds) Rheumatology subspecialty consult. Lippincott Williams & Wilkins, Philadelphia, pp 150–152

    Google Scholar 

  5. Henderson J, Cohen J, Jackson J, Wiselka M (2002) Polyarteritis nodosa presenting as a pyrexia of unknown origin. Postgrad Med J 78:685–686

    Article  PubMed  CAS  Google Scholar 

  6. Matsumoto T, Homma S, Okada M, Kuwabara N, Kira S, Hoshi T, Uekusa T, Saiki S (1993) The lung in polyarteritis nodosa: a pathologic study of 10 cases. Hum Pathol 7:717–724

    Article  Google Scholar 

  7. Guillevin L, Visser H, Noel LH, Pourrat J, Vernier I, Gayraud M, Oksman F, Lesavre P (1994) Antineutrophil cytoplasm antibodies in systemic polyarteritis nodosa with and without hepatitis B virus infection and Churg–Strauss syndrome—62 patients. J Rheumatol 21:1173–1174

    PubMed  Google Scholar 

  8. Sano K, Sakaguchi N, Ito M, Koyama M, Kobayashi, Hotchi M (2001) Histological diversity of vasculitic lesions in MPO-ANCA-positive autopsy cases. Pathol Int 51:460–466

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Shiga University of Medical Science, Seta, Otsu, 520-2192, Japan

    Toshiro Sugimoto, Keizo Kanasaki, Tetsuro Koyama, Yukiyo Yokomaku, Hitoshi Yasuda, Atsunori Kashiwagi & Daisuke Koya

Authors
  1. Toshiro Sugimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Keizo Kanasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tetsuro Koyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yukiyo Yokomaku
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hitoshi Yasuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Atsunori Kashiwagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Daisuke Koya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toshiro Sugimoto.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sugimoto, T., Kanasaki, K., Koyama, T. et al. A case of myeloperoxidase–antineutrophil cytoplasmic antibody positive-polyarteritis nodosa complicated by interstitial pneumonia and rapidly progressive renal failure. Clin Rheumatol 26, 429–432 (2007). https://doi.org/10.1007/s10067-005-0142-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-005-0142-9

Keywords

Search

Navigation