Clinical characteristics of 15 cases of microscopic polyangiitis associated with alveolar hemorrhage
10.3760/cma.j.issn.0578-1426.2015.05.008
- VernacularTitle:显微镜下多血管炎合并肺泡出血15例临床特点
- Author:
Li WANG
;
Jing LI
;
Jing ZHAO
;
Hua CHEN
;
Wenjie ZHENG
;
Qingjun WU
;
Fengchun ZHANG
- Publication Type:Journal Article
- Keywords:
Polyangiitis,microscopic;
Antibody,antineutrophil cytoplasmic;
Alveolar hemorrhage
- From:
Chinese Journal of Internal Medicine
2015;54(5):416-419
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of patients with microscopic polyangiitis (MPA) and alveolar hemorrhage (AH),so as to raise the physicians' understanding of this condition.Methods The clinical data of 15 MPA patients combined with AH,who were hospitalized in Peking Union Medical College Hospital from January 2008 to January 2014,were retrospectively analyzed.Results These 15 subjects accounted for 18.1％ of all MPA patients,including 4 males and 11 females with mean age of (59.4 ± 17.9) years old and mean disease duration of 7.5 (1-48) months.Hemoptysis or bloody sputum (14/15) and dyspnea (11/15) were predominant pulmonary manifestations.Hypoxemia appeared in 6 patients (40.0％).An average 8-46 (22.7 ± 4.4) g/L drop of hemoglobin level was seen in all 15 patients.Imaging revealed new bilateral infiltrations or opacities in 13 cases,and bloody bronchoalveolar lavage fluid were found in 6 cases.Compared with MPA patients without AH,the incidence of myalgia [2/15 vs 50.0％ (34/68) ; P =0.009,OR =0.154] and hemoglobin level [(83.2 ± 21.0) g/L vs (102.5 ± 18.7) g/L; P =0.001] were statistically lower in MPA patients with AH.There were no statistical differences in age,sex,interstitial lung disease,renal involvement,peripheral neuropathy and the five factor score between two groups.The proportion of patients who received corticosteroid pulse treatment in MPA with AH group was significantly higher than that of MPA patients without AH [9/15 vs 19.1％ (13/68) ; P =0.003,OR =6.346].After treatment,13 cases achieved remission,while 2 died.Conclusion As an important pulmonary manifestation of MPA,AH could be insidious but fatal.The treatment with steroid,cyclophosphamide and plasma exchange could improve the prognosis.
