title: Case report: severe microscopic polyangiitis successfully treated with extracorporeal membrane oxygenation and immunosuppression in a pediatric patient.
abstract: Severe microscopic polyangiitis can result in acute respiratory failure and renal failure and is commonly treated with mechanical cardiopulmonary support, along with immunosuppression. We report the use of continuous renal replacement therapy and rituximab in a 13-year-old boy with P-antineutrophil cytoplasmic antibody-positive microscopic polyangiitis, resulting in pulmonary hemorrhage and acute renal failure. The patient was treated with high-frequency oscillatory ventilation, extracorporeal membrane oxygenation, and continuous renal replacement therapy, in addition to plasmapheresis, corticosteroids, cyclophosphamide, and rituximab.
authors.affiliation: Department of Pediatrics, University of Colorado at Denver Health Sciences Center, The Children's Hospital of Denver, Aurora, Colorado, USA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Di Maria
authors.forename: Roger
authors.initials: R
authors.lastname: Hollister
authors.forename: Jon
authors.initials: J
authors.lastname: Kaufman
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D003520:Cyclophosphamide / Q000008:administration & dosage; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006612:High-Frequency Ventilation / Q000379:methods; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008171:Lung Diseases / Q000209:etiology / Q000628:therapy; D008297:Male; D010956:Plasmapheresis / Q000379:methods; D017582:Renal Replacement Therapy / Q000379:methods; D000069283:Rituximab; D012720:Severity of Illness Index; D014657:Vasculitis / Q000150:complications / Q000276:immunology / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab; D003520:Cyclophosphamide