Hoskins Michael, Thompson Grace, Navaratnam Vidya
Respiratory Department Sir Charles Gairdner Hospital Perth Australia.
Institute for Respiratory Health The University of Western Australia Perth Australia.
Respirol Case Rep. 2025 Jul 9;13(7):e70271. doi: 10.1002/rcr2.70271. eCollection 2025 Jul.
Microscopic polyangiitis (MPA) is associated with myeloperoxidase-antibody positivity and pulmonary complications. However, these antibodies may be found incidentally in some people with interstitial lung disease (ILD). As a result, management of people with ILD and myeloperoxidase-antibody positivity remains unclear. Our case series describes the natural history of this group of patients over a mean follow-up period of 4 years. Using data from a public sector pathology provider in Western Australia, we identified 17 people with a positive myeloperoxidase-antibody titre and who attended our tertiary Respiratory outpatient clinic. Eventual or concurrent diagnosis of MPA was more common in those with radiological usual interstitial pneumonia pattern, higher baseline and peak myeloperoxidase-antibody titres, lower gas transfer capacity and lower distances achieved on 6-min walk testing. These features may be used by clinicians during multidisciplinary team discussion to identify those at high-risk of developing MPA.
显微镜下多血管炎（MPA）与髓过氧化物酶抗体阳性及肺部并发症相关。然而，这些抗体可能在一些间质性肺疾病（ILD）患者中偶然发现。因此，ILD合并髓过氧化物酶抗体阳性患者的管理仍不明确。我们的病例系列描述了这组患者在平均4年随访期内的自然病程。利用西澳大利亚一家公共部门病理机构提供的数据，我们确定了17名髓过氧化物酶抗体滴度呈阳性且前来我们三级呼吸门诊就诊的患者。在那些具有放射学上常见的间质性肺炎模式、更高的基线和峰值髓过氧化物酶抗体滴度、更低的气体交换能力以及6分钟步行试验中更低行走距离的患者中，MPA的最终或同时诊断更为常见。临床医生在多学科团队讨论中可利用这些特征来识别那些发生MPA高危患者。
