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首页> 外文期刊>CEN Case Reports >AP-VAS 2012 case report: MPO-ANCA-negative relapse of MPO-ANCA-associated vasculitis
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AP-VAS 2012 case report: MPO-ANCA-negative relapse of MPO-ANCA-associated vasculitis

机译：AP-VAS 2012病例报告：MPO-ANCA相关的血管炎的MPO-ANCA阴性复发

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摘要

A 79-year-old female was admitted to our hospital with fever, proteinuria, hematuria, high levels of C-reactive protein (CRP), and high titer of myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA). Our diagnosis was microscopic polyangiitis (MPA) and she was treated with steroid pulse therapy. Clinical remission was induced; however, the disease relapsed with saddle nose and necrotizing vasculitis of the nasal cavity mucosa 1 year later. Although there was no elevation of the MPO-ANCA titer, we diagnosed the patient with relapse of MPO-ANCA-positive granulomatosis with polyangiitis (GPA). Remission was induced again with steroids and azathioprine. It has been reported that the number of MPO-ANCA-positive patients in Asian countries is relatively higher than in Western countries. We checked 29 GPA patients in our hospital and 9 patients (31.0 %) were MPO-ANCA-positive. In addition, it is not rare that an ANCA-associated vasculitis (AAV) patient who has been in remission with negative ANCA relapses without any elevation of ANCA titer. We checked the transition of ANCA titer of 24 AAV patients in our hospital who relapsed and 6 patients (25 %) relapsed without any elevation of ANCA titer. We should be careful for a relapse, even if the ANCA titer remains negative. It is also possible that ANCA had been changed so as not to be detected by the same enzyme-linked immunosorbent assay (ELISA) kit. Thus, it is also important to change the detection system if clinical symptoms are worsened while ANCA is still negative.
机译：一名79岁的女性因发热，蛋白尿，血尿，高水平的C反应蛋白（CRP）和高滴度的髓过氧化物酶抗中性粒细胞胞浆抗体（MPO-ANCA）入院。我们的诊断为镜下性多发性血管炎（MPA），她接受了类固醇脉冲治疗。导致临床缓解；然而，该病在1年后因鞍鼻和鼻腔粘膜坏死性血管炎复发。尽管MPO-ANCA滴度没有升高，但我们诊断为MPO-ANCA阳性肉芽肿病复发并伴有多血管炎（GPA）。类固醇和硫唑嘌呤再次引起缓解。据报道，亚洲国家MPO-ANCA阳性患者的数量相对高于西方国家。我们检查了我院的29名GPA患者，其中9例（31.0％）为MPO-ANCA阳性。另外，已经缓解且ANCA阴性的ANCA相关血管炎（AAV）患者复发并没有ANCA滴度升高的情况并不罕见。我们检查了我院复发的24例AAV患者的ANCA滴度过渡情况，以及6例（25％）复发的ANCA滴度没有升高的情况。即使ANCA滴度仍为阴性，我们也应小心复发。也可能已经更改了ANCA，以致不能被同一酶联免疫吸附测定（ELISA）试剂盒检测到。因此，如果临床症状恶化而ANCA仍为阴性，改变检测系统也很重要。

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  • 来源
    《CEN Case Reports》 |2013年第2期|180-183|共4页
  • 作者

    Yoshinori Komagata; Kazufumi Nomura; Ken Yoshihara; Soko Kawashima; Shinya Kaname; Yoshihiro Arimura; Akira Yamada;

  • 作者单位

    First Department of Internal Medicine Kyorin University School of Medicine">(1);

    First Department of Internal Medicine Kyorin University School of Medicine">(1);

    First Department of Internal Medicine Kyorin University School of Medicine">(1);

    First Department of Internal Medicine Kyorin University School of Medicine">(1);

    First Department of Internal Medicine Kyorin University School of Medicine">(1);

    First Department of Internal Medicine Kyorin University School of Medicine">(1);

    First Department of Internal Medicine Kyorin University School of Medicine">(1);

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  • 原文格式 PDF
  • 正文语种 eng
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  • 关键词

    ANCA-associated vasculitis; MPO-ANCA-positive GPA; Relapse; ELISA;

    机译：ANCA相关的血管炎;MPO-ANCA阳性GPA;复发;ELISA法;

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