The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Different Organ Responses to Immunosuppressive Therapy In a Microscopic Polyangiitis Patient with Interstitial Lung Disease

면역억제제 치료에 각 장기간 다른 반응을 보인 현미경 다발혈관염 1예

  • Lee, Jae Joon (Division of Nephrology, Department of Internal Medicine, Eulji University Hospital) ;
  • Shin, Jong Ho (Division of Nephrology, Department of Internal Medicine, Eulji University Hospital) ;
  • Bang, Ki Tae (Division of Nephrology, Department of Internal Medicine, Eulji University Hospital) ;
  • Choi, Ji Wook (Division of Nephrology, Department of Internal Medicine, Eulji University Hospital) ;
  • Moon, Hyun Jin (Division of Nephrology, Department of Internal Medicine, Eulji University Hospital) ;
  • Jeon, Jae Woong (Division of Nephrology, Department of Internal Medicine, Eulji University Hospital) ;
  • Jeong, Jin Uk (Division of Nephrology, Department of Internal Medicine, Eulji University Hospital)
  • 이재준 (대전 을지대학교병원 내과) ;
  • 신종호 (대전 을지대학교병원 내과) ;
  • 방기태 (대전 을지대학교병원 내과) ;
  • 최지욱 (대전 을지대학교병원 내과) ;
  • 문현진 (대전 을지대학교병원 내과) ;
  • 전재웅 (대전 을지대학교병원 내과) ;
  • 정진욱 (대전 을지대학교병원 내과)
  • Received : 2013.04.10
  • Accepted : 2013.08.12
  • Published : 2014.01.01
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Abstract

Microscopic polyangiitis (MPA) is an idiopathic autoimmune disease characterized by systemic vasculitis associated with antineutrophil cytoplasmic autoantibodies. Interstitial lung disease is a less recognized manifestation of MPA and has a poor prognosis. A 61-year-old man presented with persistent cough, sputum and dyspnea. Laboratory examination revealed microscopic hematuria and renal insufficiency. Perinuclear anti-neutrophil cytoplasmic autoantibodies were positive according to serological testing. Computed tomography scans showed bibasilar reticulation and honeycombing in a peripheral distribution. Therefore, renal biopsy was performed, and MPA was diagnosed. After treating with corticosteroids and immunosuppressive agents, the patient had a complete renal response but progressive interstitial lung disease. We report a case of MPA presenting with interstitial lung disease in which the patient experienced different responses in each organ.

Keywords

References

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