Microscopic polyangiitis presenting as idiopathic pulmonary fibrosis: is anti-neutrophilic cytoplasmic antibody testing indicated?
We report a 55-year old woman with microscopic polyangiitis who presented with idiopathic pulmonary fibrosis and 1 year later developed hematuria and proteinuria. She had a high serum level of perinuclear anti-neutrophilic cytoplasmic antibodies. Renal angiogram was normal. The diagnosis of microscopic polyangiitis was confirmed by renal biopsy, which showed pauci-immune crescentic glomerulonephritis. The patient received immunosuppressive therapy and improved markedly. Consideration of small vessel vasculitis is important in the differential diagnosis of idiopathic pulmonary fibrosis.
Department of Medicine, Queens Hospital Center, Jamaica, New York 11432, USA.
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IA
Mansi
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Opran
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Sondhi
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Ayinla
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Rosner
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis*; D005260:Female; D005921:Glomerulonephritis; D006417:Hematuria; D006801:Humans; D008875:Middle Aged; D011507:Proteinuria; D011658:Pulmonary Fibrosis / Q000150:complications / Q000175:diagnosis*; D014657:Vasculitis / Q000150:complications / Q000175:diagnosis*
D019268:Antibodies, Antineutrophil Cytoplasmic