title: Microscopic polyangiitis involving the breast.
abstract: We report a case of a 76-year-old woman, presenting with a persistent dry cough, subfebrility, arthralgia and myalgia, weight loss and a breast lesion. She has elevated inflammatory parameters, impaired renal function with proteinuria, bilateral lung nodules on computed tomography scan (CT scan) and a suspect lesion on mammography. A diagnosis of microscopic polyangiitis with involvement of the breast is made based on clinical and radiographic findings, with positive auto-immune serology and histological confirmation. Although vasculitis of the breast is uncommon, this case illustrates that when a breast lesion is found, in combination with constitutional symptoms, we should think about the possibility of an anti-Neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis. Therefore it may be important to perform auto-immune serology in these cases before proceeding to major surgery.
authors.affiliation: Department of Rheumatology, University Hospital Gent, Belgium. mieke.devinck@telenet.be
authors.forename: M
authors.initials: M
authors.lastname: Devinck
authors.forename: B
authors.initials: B
authors.lastname: Vander Cruyssen
authors.forename: K
authors.initials: K
authors.lastname: Lambein
authors.forename: F
authors.initials: F
authors.lastname: De Keyser
authors.forename: M
authors.initials: M
authors.lastname: Praet
authors.forename: G
authors.initials: G
authors.lastname: Brusselle
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D001379:Azathioprine / Q000008:administration & dosage / Q000009:adverse effects; D001940:Breast / Q000098:blood supply / Q000473:pathology; D001941:Breast Diseases / Q000175:diagnosis*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000097:blood; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008327:Mammography; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects; D055953:Microscopic Polyangiitis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D055806:Microvessels / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D001379:Azathioprine; D008775:Methylprednisolone