Aratani Sae, Sakai Yukinao, Tsuruoka Shuichi
Department of Nephrology, Graduate School of Medicine, Nippon Medical School.
J Nippon Med Sch. 2017;84(5):251-255. doi: 10.1272/jnms.84.251.
Microscopic polyangiitis (MPA) is a primary systemic vasculitis that predominantly affects small and medium vessels. MPA is rarely complicated with central nervous system or cardiovascular disease. We report a very rare case of MPA complicated with cerebral infarction, cardiovascular disease, and fatal subarachnoid hemorrhage in a 54-year-old man. During the first six days of hospitalization the patient was diagnosed with rapid progressive glomerulonephritis (RPGN), cerebral infarction, and unstable angina. According to patient's symptoms and laboratory findings, were consisted with a diagnosis of severe MPA. Steroid pulse therapy was immediately introduced. However, the patient developed massive subarachnoid hemorrhage on the 8th day of hospitalization. The condition progressively deteriorated, and the patient died on the 33rd hospital day.
显微镜下多血管炎(MPA)是一种主要累及中小血管的原发性系统性血管炎。MPA很少并发中枢神经系统或心血管疾病。我们报告一例非常罕见的54岁男性MPA病例,该病例并发脑梗死、心血管疾病及致命性蛛网膜下腔出血。在住院的头六天,患者被诊断为快速进展性肾小球肾炎(RPGN)、脑梗死和不稳定型心绞痛。根据患者症状和实验室检查结果,符合重症MPA的诊断。立即开始使用类固醇脉冲疗法。然而,患者在住院第8天发生大量蛛网膜下腔出血。病情逐渐恶化,患者于住院第33天死亡。