[Renal microscopic polyarteritis replaced by pericarditis with episodic increases in MPO-ANCA in a patient with systemic lupus erythematosus].
A 41-year-old female was admitted to our hospital with acute renal failure. The renal biopsy showed focal necrotizing crescentic glomerulonephritis, and her serology revealed a high titer of MPO-ANCA. The diagnosis of MPO-ANCA-associated microscopic polyarteritis was made, and her basic illness proved to be systemic lupus erythematosus (SLE) because of renal injury, polyarteritis, pancytopenia, anti-double-strand DNA antibody, and anti-nuclear antibodies. After treatment with prednisolone (PSL) and cyclophosphamide, her renal function improved and her MOP ANCA titer was lowered. After 2 years, she was readmitted due to dyspnea. Chest X-ray and echocardiography revealed pericarditis and bilateral pleural effusion. Renal biopsy was carried out again because of an increase in MPO-ANCA, which showed minor abnormalities. PSL therapy led to remission of pericarditis, resulting in a decrease in MPO-ANCA. In this case, MPO-ANCA is likely to be associated not with the activity of polyarteritis, but with that of SLE, and care should be taken in evaluating the clinical usefulness of MPO-ANCA in cases with SLE.
Tomori
K
K
Department of Nephrology, Saitama Medical College, Japan.
Okada
H
H
Nemoto
H
H
Sugahara
S
S
Nakamoto
H
H
Suzuki
H
H
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis / Q000502:physiology*; D001167:Arteritis / Q000209:etiology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply; D008180:Lupus Erythematosus, Systemic / Q000209:etiology* / Q000276:immunology; D010493:Pericarditis / Q000209:etiology*; D010507:Periodicity; D009195:Peroxidase / Q000276:immunology*; D012008:Recurrence
D019268:Antibodies, Antineutrophil Cytoplasmic; D009195:Peroxidase