Myeloperoxidase Antineutrophil Cytoplasmic Autoantibody : associated Glomerulonephritis in a Very Elderly Patient with Generalized Vasculitis at Autopsy

Nakamura Chie

Yorioka Noriaki

Nakanishi Schuhei

Naito Takayuki

Sugimoto Naotoshi

Kanahara Koji

Mano Masayuki

Katayama Shoichi

Ishikawa Katsunori

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

An 86-year-old woman was admitted with hemoptysis and rapid deterioration of renal function. Renal biopsy disclosed necrotizing crescentic glomerulonephritis. Based on positivity for serum myeloperoxidase antineutrophil cytoplasmic autoantibody (MPO-ANCA), MPO-ANCA-associated glomerulonephritis was diagnosed. Steroid pulse therapy was performed, but the patient died after the second course. Autopsy revealed renal vasculitis with fibrinoid necrosis extending to the level of the arcuate arteries. Vasculitis was also observed in the liver, adrenal gland, uterus, and spleen, suggesting the presence of microscopic polyarteritis. This case demonstrates the broad spectrum of MPO-ANCA-positive vasculitis and suggests the need for a more effective therapy suitable for very elderly patients.

Crescentic glomerulonephritis

Microscopic polyarteritis

MPO-ANCA

Steroid therapy

Medical sciences [ 490 ]

eng

Hiroshima University Medical Press

[ISSN] 0018-2052

[NCID] AA00664312