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冠状动脉旁路移植术后抗中性粒细胞胞浆抗体血管炎

Antineutrophil Cytoplasmic Antibody Vasculitis after Coronary Artery Bypass Grafting.

作者信息

Harris Dwight D, Sabe Sharif A, Ehsan Afshin

机构信息

Division of Cardiothoracic Surgery Department of Surgery Cardiovascular Research Center, Rhode Island Hospital Rhode Island Hospital Alpert Medical School of Brown University, Providence, Rhode Island, USA.

出版信息

Case Rep Surg. 2024 Aug 12;2024:1212538. doi: 10.1155/2024/1212538. eCollection 2024.

Abstract

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a group of rare autoimmune disorders associated with the presence of ANCA autoantibodies. We present the first reported case of acute ANCA-associated vasculitis following coronary artery bypass grafting in a 74-year-old male presenting on postoperative day 13 with shortness of breath, orthopnea, and acute kidney injury. Renal biopsy ultimately showed focal necrotizing and crescentic glomerulonephritis, and the patient was successfully managed with corticosteroids and outpatient rituximab. This rare case highlights the importance of having an expanded differential for uncommon causes of cardiovascular disease and unexpected outcomes after coronary artery bypass grafting.

摘要

抗中性粒细胞胞浆抗体(ANCA)相关性血管炎是一组与ANCA自身抗体存在相关的罕见自身免疫性疾病。我们报告了首例冠状动脉旁路移植术后发生急性ANCA相关性血管炎的病例,患者为一名74岁男性,术后第13天出现气短、端坐呼吸和急性肾损伤。肾活检最终显示局灶性坏死性和新月形肾小球肾炎,患者通过皮质类固醇和门诊利妥昔单抗治疗成功。这个罕见病例凸显了对心血管疾病不常见病因和冠状动脉旁路移植术后意外结果进行更广泛鉴别诊断的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b02/11333136/047c35c43ff7/CRIS2024-1212538.001.jpg

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