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A Case of Microscopic Polyangiitis Following Mycoplasma Infection in a Patient with MPO-ANCA Positive Pulmonary Fibrosis

Microscopic polyangiitis is a vasculitic disease that may result in a pulmonary renal syndrome. Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis is strongly associated with infection. We describe a case of microscopic polyangiitis that developed in a patient with MPO-ANCA positive p...

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Bibliographic Details
Published in:Allergology international 2011, Vol.60 (1), p.93-96
Main Authors: Takato, Hazuki, Yasui, Masahide, Waseda, Yuko, Sakai, Nobuhiko, Wada, Takashi, Fujimura, Masaki
Format: Article
Language:English
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Summary:Microscopic polyangiitis is a vasculitic disease that may result in a pulmonary renal syndrome. Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis is strongly associated with infection. We describe a case of microscopic polyangiitis that developed in a patient with MPO-ANCA positive pulmonary fibrosis following infection with mycoplasma. A renal biopsy was undertaken following the detection of microscopic hematuria during follow-up but no abnormal findings were evident. The MPO-ANCA titer increased following infection with mycoplasma pneumonia and a second renal biopsy demonstrated crescentic glomerulonephritis. The degree of pulmonary fibrosis was unaffected. The present case suggests that the mycoplasma infection triggered the elevation of MPO-ANCA titer and provoked glomerulonephritis in a patient with MPO-ANCA positive IPF. This case indicates the importance of testing for MPO-ANCA at the time of initial diagnosis, performing urinalysis and examining the urine sediment during follow-up and being alert to the potential onset of vasculitis in cases of pulmonary fibrosis.
ISSN:1323-8930
1440-1592
DOI:10.2332/allergolint.10-CR-0216