title: Microscopic polyangiitis complicated with bilateral brachial plexopathy: a case report and review of the literature.
abstract: Microscopic polyangiitis is a small-vessel necrotizing vasculitis associated with anti-neutrophil cytoplasmic antibodies and presents itself with glomerulonephritis and hemorrhagic pulmonary capillaritis. Peripheral nervous system involvement is common in anti-neutrophil cytoplasmic antibodies-associated vasculitis, but brachial plexopathy is unusual. We present the case of a 22-year-old man with known microscopic polyangiitis who was under maintenance therapy with prednisolone and cyclophosphamide and developed cough, dyspnea, and hemoptysis which increased in 6 days accompanying pain and paresthesia in the upper limbs. His physical examination revealed hypoesthesia, absence of deep tendon reflexes, and decreased muscle strength in the upper limbs. His chest computed tomography scan showed ground glass pattern in the lower and middle lobes. Electromyography and nerve conduction study showed bilateral brachial plexopathy with involvement of all of the cervical roots that were more severe in the lower roots and left side.
authors.affiliation: Connective Tissue Diseases Research Center, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Seyed Ahmad
authors.initials: SA
authors.lastname: Naseri Alavi
authors.affiliation: Connective Tissue Diseases Research Center, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Meshkini
authors.affiliation: Connective Tissue Diseases Research Center, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Tala
authors.initials: T
authors.lastname: Pourlak
authors.affiliation: Connective Tissue Diseases Research Center, Emam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. dr.khabazi@gmail.com.
authors.forename: Alireza
authors.initials: A
authors.lastname: Khabbazi
mesh_terms: D001706:Biopsy; D001917:Brachial Plexus / Q000503:physiopathology; D020516:Brachial Plexus Neuropathies / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D004576:Electromyography; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D055953:Microscopic Polyangiitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D009431:Neural Conduction; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents
keywords: Brachial plexopathy; Microscopic polyangiitis; Vasculitis