title: Vasculitis of anti-neutrophil cytoplasmic antibody after liver transplantation.
abstract: OBJECTIVE
  We reported a case of vasculitis of anti-neutrophil cytoplasmic antibody after liver transplantation. A 56-year-old male patient underwent orthotopic liver transplantation of the classic style on February 25, 2010 because of alcoholic cirrhosis.
  
  
  METHODS
  Pathology analysis showed it was nodular cirrhosis. The patient was given conventional treatment programs of FK (tacrolimus) + mycophenolate mofetil + hormone; hormone was suspended at the third month. He began to cough and spit, and there was blood in the sputum in September. Lung CT scanning images showed that there was a visible multiple low-density patchy shadow in both lungs; however, a number of other detecting results were negative.
  
  
  RESULTS
  Considering the patient with contact suspected mold, we improved the inspection and switched to experimental treatment (itraconazole), and the patient improved and was then discharged. Two months later, he complained about appearing hemoptysis. Final diagnostic results showed it was anti-neutrophil cytoplasmic antibody-associated vasculitis after liver transplantation. Then we stopped medication with itraconazole. Treatment with methylprednisolone was continued, and the patient gradually stopped coughing and had no expectoration and hemoptysis.
  
  
  CONCLUSIONS
  Reviewing CT respectively showed significant improvement at the 7th and 24th days of hormone therapy; thus, we confirmed it was anti-neutrophil cytoplasmic antibody-associated vasculitis after liver transplantation.
authors.affiliation: From the Institute of Organ Transplantation, Armed Police General Hospital, Beijing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Chen
authors.forename: Tieyan
authors.initials: T
authors.lastname: Fan
authors.forename: Xu
authors.initials: X
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Yujian
authors.initials: Y
authors.lastname: Niu
authors.forename: ZhongYang
authors.initials: Z
authors.lastname: Shen
mesh_terms: D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D003937:Diagnosis, Differential; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000276:immunology / Q000601:surgery*; D016031:Liver Transplantation; D008171:Lung Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D014057:Tomography, X-Ray Computed
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D009173:Mycophenolic Acid; D008775:Methylprednisolone