[Pulmonary involvement in patients with myeloperoxidase specific-antineutrophil cytoplasmic antibody].
In order to examine the clinical features of pulmonary involvement in patients with myeloperoxidase specific-antineutrophil cytoplasmic antibody (MPO-ANCA), 46 MPO-ANCA positive patients with collagen-vascular disease and glomerulonephritis were investigated. Twenty eight patients (60.8%) had pulmonary involvement without tumor and infection, 20 (43.5%) of MPO-ANCA positive patients had interstitial pneumonitis, 11 (23.9%) had pulmonary hemorrhage, 3 had asthma (6.5%) and 7 had both interstitial pneumonitis and pulmonary hemorrhage. Patients with pulmonary involvement were older (mean age 61.1) and they had higher inflammatory acute phase reactants and higher mortality (42.9%) than patients without pulmonary involvement. Pulmonary hemorrhage revealed on both lung fields in 10 patients, 7 patients required artificial respirator and 6 died. Titer of MPO-ANCA increased paralleled with progression of pulmonary hemorrhage. Interstitial fibrosis revealed predominantly lower and lateral side of the lung. It is suggested that MPO-ANCA may be closely related to the pathogenesis of pulmonary hemorrhage and interstitial pneumonia. Careful management is needed in patients with pulmonary involvement, especially pulmonary hemorrhage in patients with MPO-ANCA.
Arimura
Y
Y
First Department of Internal Medicine, Kyorin University, School of Medicine, Tokyo.
Minoshima
S
S
Tanaka
U
U
Fujii
A
A
Kobayashi
M
M
Nakabayashi
K
K
Kitamoto
K
K
Nagasawa
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies / Q000032:analysis*; D003095:Collagen Diseases / Q000150:complications; D005260:Female; D005921:Glomerulonephritis / Q000150:complications; D006801:Humans; D008171:Lung Diseases / Q000209:etiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000276:immunology*; D014657:Vasculitis / Q000150:complications
D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D009195:Peroxidase