title: Beneficial effect of gabexate mesilate on microscopic polyangiitis with renal dysfunction and pulmonary hemorrhage: A case report.
abstract: Corticosteroids and cyclophosphamide are the mainstay of the treatment of microscopic polyangiitis involving pulmonary hemorrhage or rapidly progressive glomerulonephritis. However, patients with advanced age are unable to tolerate this combined therapy, because of a relatively high incidence of side effects including infection, hemorrhagic cystitis, and bone marrow suppression. The authors encountered an 80-year-old patient with pulmonary hemorrhage and renal dysfunction ascribed to microscopic polyangiitis and achieved successful treatment by employing gabexate mesilate in addition to corticosteroids. The present case suggests that gabexate mesilate may be a therapeutic option for microscopic polyangiitis with progressive renal failure and pulmonary hemorrhage.
authors.affiliation: Department of Cardiology, Kyoto Prefectural Rakuto Hospital, Japan.
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Miyawaki
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tsutsumi
authors.forename: Emi
authors.initials: E
authors.lastname: Shiraishi
authors.forename: Katsuichi
authors.initials: K
authors.lastname: Ohtsuki
authors.forename: Miho
authors.initials: M
authors.lastname: Inoue
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tatsumi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Azuma
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Matsubara
mesh_terms: D000369:Aged, 80 and over; D004359:Drug Therapy, Combination; D016670:Gabexate / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008168:Lung / Q000098:blood supply*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D010488:Polyarteritis Nodosa / Q000150:complications / Q000188:drug therapy*; D051437:Renal Insufficiency / Q000188:drug therapy* / Q000209:etiology; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D015842:Serine Proteinase Inhibitors; D016670:Gabexate; D008775:Methylprednisolone