Arai Naoto, Takasaki Toshikazu, Bando Masashi, Yaoita Kei, Ueki Yutaro, Hisata Shu, Maemondo Makoto
Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.
Departments of Respiratory Medicine, University of Tokyo, 7-3-1, Hongou, Bunkyou-ku, Tokyo, 113-8655, Japan.
Respir Med Case Rep. 2024 Aug 31;51:102103. doi: 10.1016/j.rmcr.2024.102103. eCollection 2024.
Anti-neutrophil cytoplasmic antibody-associated vasculitis is triggered by infection, dust exposure, and drugs. A 73-year-old male presented with dyspnea. Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection was confirmed upon admission. Exacerbation of interstitial pneumonia and renal dysfunction were observed. Analysis revealed positivity for myeloperoxidase-anti-neutrophil cytoplasmic antibody, other anti-aminoacyl transfer RNA synthetase antibodies, and anti-melanoma differentiation-associated gene 5. Renal biopsy confirmed crescentic glomerulonephritis, leading to the diagnosis of microscopic polyangiitis. Combination therapy with prednisolone and cyclophosphamide was initiated, resulting in improved respiratory and renal failure. There is a potential association between SARS-CoV-2 infection and the onset of autoimmune diseases.
抗中性粒细胞胞浆抗体相关性血管炎由感染、接触粉尘和药物引发。一名73岁男性出现呼吸困难。入院时确诊为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染。观察到间质性肺炎和肾功能障碍加重。分析显示髓过氧化物酶抗中性粒细胞胞浆抗体、其他抗氨酰基转移RNA合成酶抗体以及抗黑色素瘤分化相关基因5呈阳性。肾活检确诊为新月体性肾小球肾炎，从而诊断为显微镜下多血管炎。开始使用泼尼松龙和环磷酰胺联合治疗，呼吸和肾衰竭情况有所改善。SARS-CoV-2感染与自身免疫性疾病的发病之间可能存在关联。
