Center for Rheumatic Disease, Iizuka Hospital, Iizuka, Fukuoka, Japan.
Mod Rheumatol. 2012 Nov;22(6):934-8. doi: 10.1007/s10165-012-0610-4. Epub 2012 Feb 22.
Giant cell arteritis (GCA) mainly involves large-sized arteries, while microscopic polyangiitis (mPA), characterized by pauci-immune necrotizing vasculitis, mainly affects small-sized vessels. We report a very rare concomitant case of GCA diagnosed by temporal artery biopsy and mPA with a high titer of myeloperoxidase antineutrophil cytoplasmic antibody, exacerbation of interstitial pneumonia, and suspected rapidly progressive glomerulonephritis. The patient died by sudden rupture of the gastroepiploic artery (medium-sized vessel), which may have been triggered by GCA and/or mPA.
巨细胞动脉炎(GCA)主要累及大动脉,而显微镜下多血管炎(mPA)以少免疫性坏死性血管炎为特征,主要影响小血管。我们报告了一例非常罕见的同时发生的 GCA 病例,该病例通过颞动脉活检和 mPA 诊断,mPA 伴有髓过氧化物酶抗中性粒细胞胞质抗体高滴度、间质性肺炎恶化和疑似快速进行性肾小球肾炎。患者因胃网膜动脉(中等大小血管)突然破裂而死亡,这可能是由 GCA 和/或 mPA 引发的。