早期診断にて軽快したMPO-ANCA関連血管炎の一例

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A 76-year-old man was admitted to our hospital for pulmonary rehabilitation. Three years before admission he was diagnosed as pulmonary emphysema. On the day of admission the patient was febrile[37-38°C]. Initially lower respiratory infection was suspected and antibioticswas given to the patient, but his fever sustained.On admission he presented proteinuria and hematuria and the following examination revealed the high titer [307U/ml] of myeloperoxidase specific anti -neutrophil cytoplasmicautoantibody (MPO-ANCA). A gradual rise in serum creatinine levels after admission was also observed. He was diagnosed as MPO-ANCA associated vasculitis. Prednisolone therapy wasstarted, which improved his symptoms and laboratory data rapidly.症例は76歳男性03年前肺気腫と診断された｡今回呼吸器リハビリテーション目的で当院に入院の運びとなった｡入院時より37-38'Cの発熱を認め,下気道感染を疑い抗生剤で加療したが改善しなかった.入院時の検尿検査で蛋白･潜血陽性であり,血清MPO-ANCAが307U/mlと高値を示した｡血清クレアチニン値も徐々に上昇してきたため,MPO-ANCA関連血管炎と診断した.プレドニゾロン投与を開始したところ,症状及び検査所見は速やかに改善した.
岡山大学医学部附属病院三朝医療センターの論文
2003-02-01