Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Japan.
Division of Respiratory Medicine and Allergology, Department of Internal Medicine, Teikyo University School of Medicine, Japan.
Intern Med. 2024 May 1;63(9):1253-1260. doi: 10.2169/internalmedicine.2512-23. Epub 2023 Sep 15.
An elderly woman showed positive conversion of myeloperoxidase (MPO)-antineutrophil cytoplasmic antibodies (ANCAs) following the diagnosis of interstitial lung disease (ILD) and glomerular hematuria and subsequently experienced slowly progressive glomerulonephritis. A kidney biopsy revealed chronic damage and necrotizing crescentic glomerulonephritis with mesangial MPO deposits. After corticosteroid treatment, the patient's urinalysis results and MPO-ANCA titers almost normalized and her renal function stabilized. This case is similar to recently reported cases of slowly progressive ANCA-associated glomerulonephritis. ILD likely triggered the production of MPO-ANCAs, and the accumulation of MPO deposits in the glomeruli may have contributed to the progression of her renal disease.
一位老年女性在诊断出间质性肺病(ILD)和肾小球性血尿后,其髓过氧化物酶(MPO)-抗中性粒细胞胞质抗体(ANCA)呈阳性转换,随后出现缓慢进展性肾小球肾炎。肾活检显示慢性损害和坏死性新月体肾小球肾炎,伴有系膜 MPO 沉积。经皮质类固醇治疗后,患者的尿分析结果和 MPO-ANCA 滴度几乎恢复正常,肾功能稳定。该病例与最近报道的缓慢进展性 ANCA 相关性肾小球肾炎的病例相似。ILD 可能引发了 MPO-ANCA 的产生,而 MPO 沉积在肾小球中的积累可能导致了她的肾脏疾病的进展。