title: Microscopic polyangiitis complicated by intracerebral hemorrhage and pulmonary hemorrhage in a pediatric patient.
abstract: METHODS
  Female, 10 FINAL DIAGNOSIS: Polyangiitis Symptoms: Intracranial hemorrhage • swelling • oliguria
  
  
  METHODS
  Cyclophosphamide • prednisolone Clinical Procedure: Plasmapheresis Specialty: Paediatric nephrology • nephrology • paediatrics.
  
  
  OBJECTIVE
  Rare disease.
  
  
  BACKGROUND
  MPO ANCA-associated vasculitis is very rare in children. Renal disease is almost universally present but lung and central nervous system involvement are not commonly reported.
  
  
  METHODS
  We present a pediatric case of microscopic polyangiitis with the unusual presentation of pauci-immune glomerulonephritis, intracerebral hemorrhage and pulmonary hemorrhage. The neurological and pulmonary symptoms settled after treatment with cyclophosphamide and plasmapheresis. However, there was no renal recovery and the patient was rendered dialysis-dependent.
  
  
  CONCLUSIONS
  We believe that this is the first reported case of pediatric microscopic polyangiitis with central nervous system involvement. The disease may have a subclinical presentation resulting in chronic damage to different organs. Prompt treatment of acute disease with immunosuppression and plasmapheresis can halt disease progression in these patients.
authors.affiliation: Department of Renal Medicine, RIPAS Hospital, Brunei Darussalam.
authors.forename: Jackson
authors.initials: J
authors.lastname: Tan
authors.forename: Asrar
authors.initials: A
authors.lastname: Hussain
authors.forename: Rajendra
authors.initials: R
authors.lastname: Daiwajna
authors.forename: Lim Kian
authors.initials: LK
authors.lastname: Chai
authors.forename: Edwin
authors.initials: E
authors.lastname: Lim
authors.forename: Aye
authors.initials: A
authors.lastname: Han
keywords: ANCA; intracerebral haemorrhage; microscopic polyangiitis; paediatric; pulmonary haemorrhage
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