Tao Tian, Lv Lizeyu, Chen Jun, Wu Ling, Liu Meijun, Tang Anqi, Yan Hong, Liu Shuqin, Zhao Liangbin
Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
J Korean Neurosurg Soc. 2025 Jul;68(4):480-487. doi: 10.3340/jkns.2023.0232. Epub 2025 May 7.
Microscopic polyangiitis (MPA) is a rare autoimmune disorder characterized by small-vessel vasculitis and the presence of anti-neutrophil cytoplasmic antibody (ANCA). Typically, MPA primarily affects the respiratory system, kidneys, and skin, with infrequent involvement of the nervous system, resulting in neuropathy. However, the occurrence of subarachnoid hemorrhage (SAH) in MPA is exceedingly rare, especially when it is accompanied by hemorrhagic events in multiple organs. This case report details the clinical presentation of a 61-yearold male patient diagnosed with MPA who experienced an exceptionally uncommon occurrence of SAH, coupled with extensive bleeding manifestations including epistaxis, skin purpura, and gastrointestinal bleeding. Notably, the patient's symptoms exhibited potential improvement following a treatment regimen consisting of rituximab and glucocorticoids. This case emphasizes the critical importance of promptly recognizing and comprehensively managing rare complications in MPA patients to optimize clinical outcomes.
显微镜下多血管炎（MPA）是一种罕见的自身免疫性疾病，其特征为小血管血管炎和抗中性粒细胞胞浆抗体（ANCA）阳性。通常，MPA主要累及呼吸系统、肾脏和皮肤，很少累及神经系统导致神经病变。然而，MPA患者发生蛛网膜下腔出血（SAH）极为罕见，尤其是伴有多器官出血事件时。本病例报告详细描述了一名61岁男性患者的临床表现，该患者被诊断为MPA，发生了极为罕见的SAH，并伴有广泛出血表现，包括鼻出血、皮肤紫癜和胃肠道出血。值得注意的是，在接受利妥昔单抗和糖皮质激素治疗方案后，患者症状有改善的趋势。本病例强调了及时识别和全面管理MPA患者罕见并发症对于优化临床结局的至关重要性。
