Yoshida A, Takeda A, Koyama K, Morozumi K
Division of Nephrology, Nagoya Daini Red Cross Hospital.
Ryumachi. 1996 Jun;36(3):570-3.
We describe two cases (61-year-old female and 71-year-old male) with MPO-ANCA (myeloperoxidase-antineutrophil cytoplasmic antibody) positive who developed severe interstitial pneumonitis. They presented at our hospital with dyspnea and dry cough. The hypoxia and abnormal shadow on chest X-ray led to a diagnosis of interstitial pneumonitis. Serologic studies revealed the high titers of MPO-ANCA in two cases. They were treated with methylprednisolone, immunosuppressant agents and plasma exchange. The pneumonitis and the titers of MPO-ANCA improved on these therapies, The former was introduced continuous hemodialysis therapy and the later continued nephrotic syndrome. These renal damages did not recover, regardless of the reduction of the titers of MPO-ANCA. It is concluded that methylprednisolone pulse therapy, immunosuppressant agents and plasma exchange therapy are useful to interstitial pneumonitis in patient with positive of MPO-ANCA. The measurement of MPO-ANCA is useful to interstitial pneumonitis in patient with positive of MPO-ANCA. The measurement of MPO-ANCA is useful maker of interstitial pneumonitis for unknown causes.
我们描述了两例(一名61岁女性和一名71岁男性)髓过氧化物酶抗中性粒细胞胞浆抗体(MPO-ANCA)阳性且发生严重间质性肺炎的病例。他们因呼吸困难和干咳前来我院就诊。低氧血症及胸部X线异常阴影导致间质性肺炎的诊断。血清学研究显示两例患者MPO-ANCA滴度均高。他们接受了甲泼尼龙、免疫抑制剂及血浆置换治疗。在这些治疗下,肺炎及MPO-ANCA滴度有所改善,前者接受了持续血液透析治疗,后者持续患有肾病综合征。尽管MPO-ANCA滴度降低,但这些肾脏损害并未恢复。结论是甲泼尼龙冲击疗法、免疫抑制剂及血浆置换疗法对MPO-ANCA阳性患者的间质性肺炎有效。MPO-ANCA检测对MPO-ANCA阳性患者的间质性肺炎有用。MPO-ANCA检测是不明原因间质性肺炎的有用标志物。