title: Onset of Microscopic Polyangiitis in Binephrectomied Patient on Chronic Hemodialysis-Case Report.
abstract: BACKGROUND
  Microscopic polyangiitis (MPA) is one of the causes of the pulmonary-renal syndrome associated with elevated non-specific markers of inflammation and antineutrophil cytoplasmic autoantibody (ANCA) positivity in 50-75%.De novooccurrence of the disease in patients on chronic hemodialysis (HD) has not been described.
  
  
  METHODS
  We presented patient who developed MPO-ANCA-associated MPA with lung and musculoskeletal involvement after 4 years on regular HD due to bilateral nephrectomy. After excluding the other causes of MPO-ANCA positivity, diagnosis was confirmed even without renal biopsy. Patient received standard immunosuppression therapy and he is still in remission after 27 months.
  
  
  CONCLUSIONS
  The onset of immune-mediated disease could be observed even after introduction of renal replacement therapy, which may be a diagnostic problem. Early recognition and traditional immunosuppressive regiment may provide successful outcome.
authors.affiliation: Clinical Department for Nephrology with Dialysis, University Medical Center Zvezdara , Belgrade , Serbia.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Jankovic
authors.affiliation: Clinical Department for Nephrology with Dialysis, University Medical Center Zvezdara , Belgrade , Serbia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Maslarevic-Radovic
authors.affiliation: Clinical Department for Nephrology with Dialysis, University Medical Center Zvezdara , Belgrade , Serbia.
authors.forename: Petar
authors.initials: P
authors.lastname: Djuric
authors.affiliation: Clinical Department for Nephrology with Dialysis, University Medical Center Zvezdara , Belgrade , Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Tosic-Dragovic
authors.affiliation: Clinical Department for Nephrology with Dialysis, University Medical Center Zvezdara , Belgrade , Serbia.
authors.forename: Ana
authors.initials: A
authors.lastname: Bulatovic
authors.affiliation: Clinical Department for Nephrology with Dialysis, University Medical Center Zvezdara , Belgrade , Serbia.
authors.forename: Nikola
authors.initials: N
authors.lastname: Simovic
authors.affiliation: Clinical Department for Nephrology with Dialysis, University Medical Center Zvezdara , Belgrade , Serbia.
authors.forename: Milos
authors.initials: M
authors.lastname: Mitrovic
authors.affiliation: Clinical Department for Nephrology with Dialysis, University Medical Center Zvezdara , Belgrade , Serbia.
authors.forename: Verica
authors.initials: V
authors.lastname: Stankovic-Popovic
authors.affiliation: Clinical Department for Pulmonology, University Medical Center Zvezdara , Belgrade , Serbia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Dopudja-Pantic
authors.affiliation: Institute for Allergology and Immunology, Clinical Center Serbia , Belgrade , Serbia.
authors.forename: Snezana
authors.initials: S
authors.lastname: Arandjelovic
authors.affiliation: Clinical Department for Nephrology with Dialysis, University Medical Center Zvezdara, Belgrade, Serbia; Medical Faculty, Belgrade University, Belgrade, Serbia.
authors.forename: Nada
authors.initials: N
authors.lastname: Dimkovic
keywords: MPO-ANCA; binephrectomy; chronic hemodialysis; microscopic polyangiitis; pulmo