Department of Infection Control Science, Graduate School of Medicine, Osaka City University, Japan.
Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Japan.
Intern Med. 2023 Jan 1;62(1):129-133. doi: 10.2169/internalmedicine.9599-22. Epub 2022 May 31.
We herein report a case of muscle biopsy-proven microscopic polyangiitis (MPA) in a patient with tuberculosis. The patient had developed a persistent fever after the initiation of treatment for tuberculosis and was positive for myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA). However, because conventional symptoms were lacking, determination of the biopsy site was difficult. Based on the findings of a biopsy of the biceps femoris, which confirmed small vessel vasculitis, the patient was diagnosed with MPA. The fever was alleviated by glucocorticoids. Tuberculosis and antituberculosis drugs can cause ANCA-associated vasculitis (AAV). A muscle biopsy is useful for the diagnosis of AAV.
我们在此报告一例经肌肉活检证实的结核患者伴发显微镜下多血管炎（MPA）。该患者在开始治疗结核病后出现持续发热，且髓过氧化物酶-抗中性粒细胞胞质抗体（MPO-ANCA）阳性。然而，由于缺乏典型症状，确定活检部位较为困难。根据肱二头肌活检结果（证实存在小血管血管炎），该患者被诊断为 MPA。经糖皮质激素治疗后，发热症状得到缓解。结核病及抗结核药物可导致抗中性粒细胞胞质抗体相关性血管炎（AAV）。肌肉活检有助于 AAV 的诊断。
