Extensive pancreatic necrosis in microscopic polyangiitis.
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.
Haraguchi
Kazutaka
K
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan. kazutaka@res.yamanashi-med.ac.jp.
Gunji
Kazuaki
K
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
Ito
Yuko
Y
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
Yokomori
Nobuhiko
N
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
Kawaguchi
Akio
A
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
Ohomori
Masayuki
M
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
Inoue
Hironobu
H
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
Shimura
Hiroki
H
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
Saito
Tsukasa
T
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
Kobayashi
Tetsuro
T
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
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*