title: [A case of microscopic polyangiitis relapsed with diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis].
abstract: The patient was a 63-year-old woman. She was admitted to our hospital with acute renal failure and multiple mononeuritis in 2002. She was diagnosed as microscopic polyangiitis based on positive for MPO-ANCA. Remission was induced by combination therapy with methylprednisolone pulse therapy and plasma exchange. Because condition of the disease was stable, prednisolone was discontinued from August 2006. Elevation of serum creatinine and microscopic hematuria was detected in November 2007. Fever and dyspnea occurred in January 24 2008. Elevation of CRP and serum creatinine was found, and infiltration in bilateral lung was noted on chest X-ray. She was admitted on the same day. After admission, she presented with hemosputum and exacerbation of dyspnea. Chest CT revealed diffuse consolidation and ground glass opacity, and MPO-ANCA converted to be positive. Diagnosis of diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis with microscopic polyangiitis was made, and she was managed by artificial respirator and CHDF in ICU. Combination therapy with steroid pulse therapy and plasma exchange re-induced remission. Mizoribine was administrated as maintenance therapy with oral prednisolone.
authors: Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University.
authors: Shinya
authors: S
authors: Kawashiri
authors: Atsushi
authors: A
authors: Kawakami
authors: Naoki
authors: N
authors: Iwamoto
authors: Keita
authors: K
authors: Fujikawa
authors: Toshiyuki
authors: T
authors: Aramaki
authors: Kunihiro
authors: K
authors: Ichinose
authors: Makoto
authors: M
authors: Kamachi
authors: Mami
authors: M
authors: Tamai
authors: Kazuhiko
authors: K
authors: Arima
authors: Hideki
authors: H
authors: Nakamura
authors: Masako
authors: M
authors: Kita
authors: Hiroaki
authors: H
authors: Ida
authors: Tomoki
authors: T
authors: Origuchi
authors: Katsumi
authors: K
authors: Eguchi
mesh_terms: D005260:Female; D005921:Glomerulonephritis / Q000150:complications*; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D008875:Middle Aged; D011650:Pulmonary Alveoli; D012008:Recurrence; D014657:Vasculitis / Q000150:complications* / Q000628:therapy