Mackay James
James Paget University Hospital, Great Yarmouth, UK.
BMJ Case Rep. 2011 Jul 27;2011:bcr0620114336. doi: 10.1136/bcr.06.2011.4336.
A 77-year-old gentleman, a holidaymaker in the area, presented with a 2-month history of cough productive of rust-coloured sputum and exertional dyspnoea. His initial chest x-ray showed bibasal interstitial shadowing. He then deteriorated rapidly to type 1 respiratory failure with acute renal failure. A CT chest showed bilateral alveolar haemorrhage. Testing for p-anti-neutrophil cytoplasmic antibody was strongly positive, with an anti-myeloperoxidase antibody titre of 198 units/ml (normal range 0-6 units/ml). A diagnosis of microscopic polyangitis was made. Following treatment with plasma exchange, cyclophosphamide and steroids, he made a good recovery.
一位77岁的男性，该地区的度假者，出现咳嗽伴铁锈色痰2个月及劳力性呼吸困难。他最初的胸部X光显示双肺底部间质阴影。随后他迅速恶化为1型呼吸衰竭并伴有急性肾衰竭。胸部CT显示双侧肺泡出血。抗中性粒细胞胞浆抗体检测呈强阳性，抗髓过氧化物酶抗体滴度为198单位/毫升（正常范围0 - 6单位/毫升）。诊断为显微镜下多血管炎。经过血浆置换、环磷酰胺和类固醇治疗后，他恢复良好。
