Nodular pulmonary vasculitis in a twelve-year-old boy.
A 12-year-old boy presented with left shoulder pain during physical exercise and complained of uncommon sweating and fatigue. Diagnostic evaluation revealed a solitary pulmonary nodule in the left upper lobe. All laboratory values were within normal limits, except for an elevated level of antineutrophil cytoplasmic antibodies directed against myeloperoxidase (p-ANCA). Surgery was performed, and pathological examination showed a localized granulomatous vasculitis. Antineutrophil cytoplasmic antibodies directed against affinity purified proteinase 3 (p-ANCA) concentrations returned to baseline within 6 months, and the patient has done well during a follow-up period of 2 years. While nodular vasculitis is known to occur in Wegener's granulomatosis, to the best of our knowledge, this case represents the first c-ANCA negative primary pulmonary vasculitis in childhood.
Borchers
T
T
Children's Hospital, University of Essen, Essen, Germany. tanja.borchers@uni-essen.de
Dirsch
O
O
Schaper
J
J
Kreuzfelder
E
E
Jakob
H
H
Ratjen
F
F
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000378:metabolism; D002648:Child; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000601:surgery; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D014657:Vasculitis / Q000175:diagnosis*
D019268:Antibodies, Antineutrophil Cytoplasmic