[Alveolar hemorrhage and glomerulonephritis in two patients with anti-neutrophil cytoplasmic antibodies].

A 55-year-old woman and a 56-year-old woman were admitted to the hospital because of dyspnea on exertion and bloody sputum. Chest roentgenography and computed tomography showed bilateral infiltrative shadows. Examination of bronchoalveolar lavage fluid and of specimens obtained by transbronchial lung biopsy revealed alveolar hemorrhage and hemosiderin-laden macrophages. Examination of specimens obtained by needle biopsies of the kidneys showed glomerulonephritis. Test for anti-neutrophil cytoplasmic antibody (ANCA) were positive; alveolar hemorrhage and glomerulonephritis accompanied by ANCA-related vasculitis was diagnosed. The patients' condition improved with administration of prednisolone and cyclophosphamide. Measurement of ANCA was useful for monitoring the activity of the disease.