Haraguchi Kazutaka, Gunji Kazuaki, Ito Yuko, Yokomori Nobuhiko, Kawaguchi Akio, Ohomori Masayuki, Inoue Hironobu, Shimura Hiroki, Saito Tsukasa, Kobayashi Tetsuro
Third Department of Internal Medicine, University of Yamanashi, 1110 Tamaho, Nakakoma, Yamanashi, 409-3898, Japan.
Clin Exp Nephrol. 2005 Dec;9(4):326-331. doi: 10.1007/s10157-005-0378-3.
We encountered an 84-year-old woman with microscopic polyangiitis who was found to have pancreatitis on autopsy. The patient was admitted to Yamanashi University Hospital because of fever and progressive renal failure. She was diagnosed with anti-myeloperoxidase (MPO)-antineutrophil cytoplasmic antibody (ANCA)-related microscopic polyangiitis (MPA) and was treated successfully with prednisolone pulse therapy. Two months later, she was found unconscious at home and was transferred to hospital, where she died of cardiac arrest after 6 days. Autopsy revealed systemic vasculitis with fibrinoid necrosis (with the most severe form found in the pancreas), interstitial pneumonia, and crescentic glomerulonephritis. A review of the literature revealed that pancreatic involvement in vasculitis, although rare, is one of the complications of MPA; however, the present study is the first report to focus on the pancreatic involvement of MPA. We recommend that nephrologists consider the possibility of pancreatic involvement in this disease.
我们遇到一名84岁患有显微镜下多血管炎的女性，尸检发现她患有胰腺炎。该患者因发热和进行性肾衰竭入住山梨大学医院。她被诊断为抗髓过氧化物酶（MPO）-抗中性粒细胞胞浆抗体（ANCA）相关的显微镜下多血管炎（MPA），并通过泼尼松龙脉冲疗法成功治疗。两个月后，她在家中被发现昏迷，随后被送往医院，6天后因心脏骤停死亡。尸检显示全身性血管炎伴纤维素样坏死（胰腺中最为严重）、间质性肺炎和新月形肾小球肾炎。文献回顾显示，血管炎累及胰腺虽然罕见，但却是MPA的并发症之一；然而，本研究是首篇聚焦于MPA胰腺受累情况的报告。我们建议肾脏病学家考虑本病胰腺受累的可能性。
