Microscopic Polyangiitis : A Case Report
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Abstract
The author reported a 47-year old Thai man who presented with acute respiratory failure from diffuse alveolar hemorrhage and rapidly progressive glomerulonephritis due to small vessel vasculitis. Treatment in medical intensive care unit included respiratory support by respirator, intraperitoneal dialysis, intravenous methylprednisolone and antibiotic administration. Because of very severely active disease, the patient died 5 hours after starting treatment and carefully monitoring. Laboratory investigation revealed positive serum p-ANCA 1:320. Microscopic polyangiitis was the most likely diagnosis. This report aimed to identify pitfalls in diagnosis and review the literatures of this disease.
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บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
References
Stephen KF, Gregory PC, Aryeh F. Update in the diagnosis and management of pulmonary vasculitis. Chest 2006; 129: 452-65.
Lhote F, Guillevin L. Polyarteritis nodosa, microscopic polyangiitis and Churg-Strauss syndrome. Semin Resp Crit Care Med 1998; 19: 27-45.
Marvin IS, Harold RC, Talmadge EK. Diffuse alveolar hemorrhage and other rare infiltrative disorders. In: Robert JM, John FM, V. Courtney B, Jay AN, editors. Textbook of respiratory medicine. 4th ed. Philadelphia:Elseveir Saunders; 2005. p. 1656-78.
Jayne D, Rasmussen N, Andrassy K, Bacon P, Terveart JW, Dadoniene’ J, et al. A randomized trial of maintenance therapy for vasculitis associated with antineutrophilic cytoplasmic antibodies. N Engl J Med 2003; 349: 36-44.
Belmont HM. Treatment of ANCA-associated systemic vasculitis. Bull NYU Hosp Jt Dis 2006; 64(1- 2): 60-6.
Watts RA, Lane SE, Bentham G, Scott DG. Epidemiology of systemic vasculitis: a ten-year study in the United Kingdom. Arthritis Rheum 2000; 43: 414-9.
Reinhold KE, Herlyn K, Wagner BR, Gross WL. Stable incidence of primary systemic vasculitides over five years: results from the German vasculitis register. Arthritis Rheum 2005; 53: 93-9.
Glassock RJ. Hematuria and pigmenturia. In: Massary SG, Glassock RJ, editors. Textbook of nephrology. Baltimore: Williams of Wilkins; 1989. p. 491-5.
Hugh RB, Yvonne MO, Barry MB. The major glomerulopathies. In: Eugene B, Anthony SF, Dennis LK, editors. Harrison’s principles of internal medicine. 15th ed. New York: Mcgraw-Hill; 2001. p. 1580-9.
Birch DF, Failey KF, Whitworth JA, Forbes I, Fairley JK, Cheshire GR, et al. Urinary erythrocyte morphology in the diagnosis of the glomerular hematuria. Clin Nephrol 1983; 20: 78-85.
Levy JB, Turner AN, Rees AJ, Pusey CD. Long-term outcome of anti-glomerular basement membrane antibody disease treated with plasma exchange and immunosuppression. Ann Intern Med 2001; 134: 1033-42 .
Keller F, Offermann G, Schultze G, Wagner K, Aulbert E, Scholle J, et al. Membrane plasma exchange in Goodpasture’s syndrome. Am J Med Sci 1984; 287: 32-6.
Thomasow BM, Felton CP, Navarro C. Diffuse intrapulmonary hemorrhage, renal failure and a systemic vasculitis: a case report and review of the literature. Am J Med 1980; 68: 299-304.
Imoto EM, Lombard CM, Sachs DP. Pulmonary capillaritis and hemorrhage: a clue to the diagnosis of systemic necrotizing vasculitis. Chest 1989; 96: 927-8.
Haworth SJ, Savage CO, Carr D, Hughes JM, Rees AJ. Pulmonary hemorrhage complicating Wegener’s granulomatosis and microscopic polyarteritis. Br Med J (Clin Res Ed) 1985; 290: 1775-8.
Savage CO, Winearls CG, Evans DJ, Rees AJ, Lockwood CM. Microscopic polyarteritis: presentation, pathology and prognosis. Q J Med 1985; 56: 467-83.