Bando Masashi, Homma Sakae, Harigai Masayoshi
Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan.
Department of Advanced and Integrated Interstitial Lung Diseases Research, School of Medicine, Toho University, Tokyo, Japan.
Sarcoidosis Vasc Diffuse Lung Dis. 2022;38(4):e2021045. doi: 10.36141/svdld.v38i4.11808. Epub 2022 Jan 13.
Although interstitial pneumonia is an important respiratory manifestation in microscopic polyangiitis (MPA), no studies have examined the detailed pathogenesis of interstitial pneumonia during the clinical course of MPA. In addition, it is considered that MPA develops at a certain incidence rate from myeloperoxidase (MPO)- antineutrophil cytoplasmic antibody (ANCA) positive interstitial pneumonia. However, there is a lack of consensus among pulmonologist and rheumatologist regarding whether MPO-ANCA positive interstitial pneumonia, which does not accompany other organ damage related to ANCA-associated vasculitis (AAV) other than interstitial pneumonia, should be included in AAV. In this review article, the clinical questions regarding MPO-ANCA positive interstitial pneumonia have been set, and evidence to date and problems to be solved in future are outlined.
尽管间质性肺炎是显微镜下多血管炎(MPA)的一种重要肺部表现,但尚无研究探讨MPA临床过程中间质性肺炎的详细发病机制。此外,有人认为MPA以一定发病率由髓过氧化物酶(MPO)-抗中性粒细胞胞浆抗体(ANCA)阳性的间质性肺炎发展而来。然而,对于不伴有除间质性肺炎以外的其他与ANCA相关血管炎(AAV)相关器官损害的MPO-ANCA阳性间质性肺炎是否应纳入AAV,肺科医生和风湿科医生之间尚未达成共识。在这篇综述文章中,提出了关于MPO-ANCA阳性间质性肺炎的临床问题,并概述了迄今的证据和未来有待解决的问题。