title: Extensive pancreatic necrosis in microscopic polyangiitis.
abstract: We encountered an 84-year-old woman with microscopic polyangiitis who was found to have pancreatitis on autopsy. The patient was admitted to Yamanashi University Hospital because of fever and progressive renal failure. She was diagnosed with anti-myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA)-related microscopic polyangiitis (MPA) and was treated successfully with prednisolone pulse therapy. Two months later, she was found unconscious at home and was transferred to hospital, where she died of cardiac arrest after 6 days. Autopsy revealed systemic vasculitis with fibrinoid necrosis (with the most severe form found in the pancreas), interstitial pneumonia, and crescentic glomerulonephritis. A review of the literature revealed that pancreatic involvement in vasculitis, although rare, is one of the complications of MPA; however, the present study is the first report to focus on the pancreatic involvement of MPA. We recommend that nephrologists consider the possibility of pancreatic involvement in this disease.
authors.affiliation: Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan. kazutaka@res.yamanashi-med.ac.jp.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Haraguchi
authors.affiliation: Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Gunji
authors.affiliation: Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Yokomori
authors.affiliation: Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Kawaguchi
authors.affiliation: Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohomori
authors.affiliation: Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Inoue
authors.affiliation: Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shimura
authors.affiliation: Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Saito
authors.affiliation: Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D000369:Aged, 80 and over; D017809:Fatal Outcome; D005260:Female; D005921:Glomerulonephritis / Q000473:pathology*; D006801:Humans; D009336:Necrosis; D010179:Pancreas / Q000473:pathology*; D010195:Pancreatitis / Q000473:pathology*; D014657:Vasculitis / Q000473:pathology*