title: Myeloperoxidase antineutrophil cytoplasmic autoantibody-associated glomerulonephritis in a very elderly patient with generalized vasculitis at autopsy.
abstract: An 86-year-old woman was admitted with hemoptysis and rapid deterioration of renal function. Renal biopsy disclosed necrotizing crescentic glomerulonephritis. Based on positivity for serum myeloperoxidase antineutrophil cytoplasmic autoantibody (MPO-ANCA), MPO-ANCA-associated glomerulonephritis was diagnosed. Steroid pulse therapy was performed, but the patient died after the second course. Autopsy revealed renal vasculitis with fibrinoid necrosis extending to the level of the arcuate arteries. Vasculitis was also observed in the liver, adrenal gland, uterus, and spleen, suggesting the presence of microscopic polyarteritis. This case demonstrates the broad spectrum of MPO-ANCA-positive vasculitis and suggests the need for a more effective therapy suitable for very elderly patients.
authors.affiliation: Department of Internal Medicine, Kure National Hospital, Japan.
authors.forename: C
authors.initials: C
authors.lastname: Nakamura
authors.forename: N
authors.initials: N
authors.lastname: Yorioka
authors.forename: S
authors.initials: S
authors.lastname: Nakanishi
authors.forename: T
authors.initials: T
authors.lastname: Naito
authors.forename: N
authors.initials: N
authors.lastname: Sugimoto
authors.forename: K
authors.initials: K
authors.lastname: Kanahara
authors.forename: M
authors.initials: M
authors.lastname: Mano
authors.forename: S
authors.initials: S
authors.lastname: Katayama
authors.forename: K
authors.initials: K
authors.lastname: Ishikawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology*; D001323:Autoantibodies / Q000276:immunology*; D005260:Female; D005921:Glomerulonephritis / Q000150:complications* / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D009195:Peroxidase / Q000276:immunology*; D014657:Vasculitis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D009195:Peroxidase