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首页> 外文期刊>Pathology International >Identification of MPO-positive capillaries of the pleura by immunohistochemistry in MPO-ANCA associated vasculitis.
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Identification of MPO-positive capillaries of the pleura by immunohistochemistry in MPO-ANCA associated vasculitis.

机译：通过免疫组织化学在MPO-ANCA相关性血管炎中鉴定胸膜MPO阳性毛细血管。

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摘要

We present a case of a middle-aged woman with myeloperoxidase anti-neutrophil cytoplasmic autoantibody (MPO-ANCA)-associated vasculitis that demonstrated immunohistochemically positive MPO capillaries of the pleura. The patient initially presented with proteinuria and microscopic hematuria at the age of 38. Acute progressive glomerulonephritis and pulmonary hemorrhage occurred 4 years later, and a high serum titer of MPO-ANCA was detected therefore a diagnosis of microscopic polyangiitis was made. Steroid-pulse therapy was performed and the pulmonary shadow improved, but the renal failure did not improve, thus, hemodialysis was initiated. Thereafter, an 18-year asymptomatic phase followed, but high serum levels of MPO-ANCA persisted during this period. Chronic pulmonary hemorrhage was discovered at the age of 60, and video-assisted thoracoscopic surgery was performed. Resected tissue revealed diffuse aloveolar hemorrhage accompanied by marked hemosiderin deposition, whereas MPO-immunopositive capillaries were identified only in the pleura. To our knowledge, this is the first report demonstrating MPO-positive capillaries in a disease other than glomerulonephritis. Judging from this unique case, MPO-positive endothelial cells may appear only during the hyperacute stage before hemorrhage, and may diminish thereafter, thus, may be associated with the trigger of microscopic polyangiitis.
机译：我们介绍了一个中年妇女与髓过氧化物酶抗中性粒细胞胞浆自身抗体（MPO-ANCA）相关的血管炎的病例，该病例显示了胸膜的免疫组织化学阳性MPO毛细血管。患者最初在38岁时出现蛋白尿和镜下血尿。4年后发生了急性进行性肾小球肾炎和肺出血，并检测到MPO-ANCA血清滴度高，因此诊断为镜下多血管炎。进行类固醇脉冲疗法并改善了肺部阴影，但肾功能衰竭并未改善，因此开始了血液透析。此后，为期18年的无症状期，但在此期间，高血清MPO-ANCA持续存在。 60岁时发现了慢性肺出血，并进行了电视胸腔镜手术。切除的组织显示弥漫性小肠出血，伴有明显的铁血黄素沉积，而MPO免疫阳性的毛细血管仅见于胸膜。据我们所知，这是第一个证明MPO阳性毛细血管在肾小球肾炎以外的疾病中的报道。从这种独特的情况来看，MPO阳性内皮细胞可能仅在出血前的超急性期出现，此后可能减少，因此可能与微观多发性血管炎的触发有关。

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