title: Early interstitial lung disease in microscopic polyangiitis: Case report and literature review.
abstract: Microscopic polyangiitis (MPA) is a systemic disease included in the Chapel Hill 2012 Classification as necrotizing vasculitis affecting capillaries, venules and arterioles. It usually expresses antineutrophil cytoplasmic antibodies (ANCA) and has a perinuclear immunofluorescence pattern and correlation with anti-myeloperoxidase (MPO) antibodies. Capillaritis with alveolar hemorrhage is the most common manifestation of lung disease. Interstitial lung disease (ILD) is uncommon, with usual interstitial pneumonia being the predominant pattern. However, other patterns such as organizing pneumonia have been described. No guidelines exist for treating patients with ILD and, currently, ANCA-associated vasculitis (AAV) is managed along the lines of small vessel vasculitis. The prognosis with this association is uncertain, with possibilities of relapse and a fatal outcome. We present a case in which ILD was the first manifestation of MPA, without alveolar hemorrhage, with subsequent renal involvement and, in which, the established treatment produced a significant clinical improvement.
authors.affiliation: Servicio de Medicina Interna, Centro Médico ISSEMyM Toluca, Metepec, Estado de México, México. Electronic address: mark_g_n@hotmail.com.
authors.forename: Marcos
authors.initials: M
authors.lastname: García-Nava
authors.affiliation: Clínica de enfermedades intersticiales del pulmón, Instituto Nacional de Enfermedades Respiratorias.
authors.forename: Heidegger
authors.initials: H
authors.lastname: Mateos-Toledo
authors.affiliation: Servicio de Medicina Interna, Centro Médico ISSEMyM Toluca, Metepec, Estado de México, México.
authors.forename: Ana Patricia Georgina
authors.initials: APG
authors.lastname: Guevara-Canseco
authors.affiliation: Servicio de Medicina Interna, Centro Médico ISSEMyM Toluca, Metepec, Estado de México, México.
authors.forename: Cesar Eduardo
authors.initials: CE
authors.lastname: Infante-González
authors.affiliation: Servicio de Medicina Interna, Centro Médico ISSEMyM Toluca, Metepec, Estado de México, México.
authors.forename: Diego Alberto
authors.initials: DA
authors.lastname: Reyes-Nava
authors.affiliation: Servicio de Medicina Interna, Centro Médico ISSEMyM Toluca, Metepec, Estado de México, México.
authors.forename: Emilio
authors.initials: E
authors.lastname: Estrada-Castro
mesh_terms: D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D055953:Microscopic Polyangiitis / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged
keywords: Enfermedad pulmonar intersticial; Interstitial lung disease; Microscopic polyangiitis; Organizing pneumonia pattern; Patrón de neumonía organizada; Poliangeítis microscópica