A Case of Microscopic Polyangiitis with Pulmonary Hemorrhage and Rapidly Progressive Glomerulonephritis.
- Author:
Hae Sik KWON
1
;
Young Mock LEE
;
Ji Hong KIM
;
Pyung Kil KIM
;
Hae Youn KANG
;
Soon Won HONG
;
Hyeon Joo JEONG
Author Information
1. Department of Pediatrics, The Institute of Kidney Disease Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Antineutrophil cytoplasmic autoantibodies;
Systemic vasculitis;
Renal biopsy;
Alveolar hemorrhage;
Gastrointestinal bleeding
- MeSH:
Antibodies, Antineutrophil Cytoplasmic;
Biopsy;
Cyclophosphamide;
Cytoplasm;
Diagnosis;
Glomerulonephritis*;
Hemorrhage*;
Humans;
Kidney;
Lung;
Methylprednisolone;
Microscopic Polyangiitis*;
Outpatients;
Plasmapheresis;
Proteinuria;
Systemic Vasculitis;
Vasculitis
- From:Journal of the Korean Society of Pediatric Nephrology
2001;5(2):213-218
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Microscopic Polyangiitis(MPA) belongs to a spectrum of systemic vasculits, and particularly antineutrophil cytoplasmic autoantibodies(ANCA)-associated small-vessel vasculitis which is characterized by involvement of the lung and kidney. The diagnosis of MPA is often difficult to make, and delayed because of the variability of the clinical presentation. Renal biopsies have a very important diagnostic and prognostic value in MPA. We experienced a case of microscopic polyangiits which was confirmed by renal biopsy and positive serum perinuclear ANCA, associated with alveolar hemorrhage and gastrointestinal bleeding. We began methylprednisolone pulse therapy, combined with a low dose of cyclophosphamide and plasmapheresis therapy. ACE inhibitor and Ca channel blocker were used when proteinuria and hypertention developed. On admission, the patient's lab findings showed BUN 117 mg/dL, Cr 2.3 mg/dL, while on the 60th hospital day BUN/Cr values fell to 20.8 mg/dL / 1.6 mg/dL and though proteinuria persisted, the patient's condition was tolerable and is currently under observation on an out-patient basis. The last lab values were BUN 26 mg/dL / Cr 1.6 mg/dL.
