Microscopic polyangiitis

Česká verzia

Authors: Daniel Tobiáš; Kristína Brázdilová; Zdenko Killinger; Juraj Payer
Authors place of work: V. interná klinika LF UK a UN Bratislava, Nemocnica Ružinov, Slovenská republika
Published in the journal: Vnitř Lék 2020; 66(4): 249-252
Category: Case Report

Summary

Microscopic polyangiitis is a rare, systemic, necrotizing, pauci-immune, ANCA associated small vessel vasculitis, with no evidence of granulomatous inflammation. Diagnosing microscopic polyangiitis is often difficult because of it´s presentation by a number of non-specific symptoms. We treated a 35-year old patient, who was admitted for migrating arthritis and fever with papulous rash. In this case, we want to point out the importance of considering the diagnosis of MPA and similar rare diseases in the process of differential diagnosis, mainly in patients presenting with non-specific symptoms, because the mortality of this disease without adequate treatment is alarmingly high.

Keywords:

vasculitis – Pancreatitis – ANCA – glomerulonephritis – cerebritis – polyangiitis

Zdroje

1. Chung SA, Seo P Microscopic polyangiitis. Rheum Dis Clin North Am 2010; 36: 545–558.

2. Fries JF, Hunder GG, Bloch DA et al. The American College of Rheumatology 1990 criteria for the classification of vasculitis. Summary. Arthritis Rheum 1990; 33: 1135–1136.

3. Jennette JC, Falk RJ, Andrassy K et al. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum. 1994; 37: 187–192.

4. Lightfoot RW, Michel BA, Bloch DA et al. The American College of Rheumatology 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum 1990; 33: 1088–1093.

5. Amezcua‑Guerra LM, Prieto P, Bojalil R et al. Microscopic polyangiitis associated with primary biliary cirrhosis: a causal or casual association? J Rheumatol 2006; 33: 2351–2353.

6. Seligman VA, Bolton PB, Sanchez HC et al. Propylthiouracil‑induced microscopic polyangiitis. J Clin Rheumatol 2001; 7: 170–174.

7. Altaie R, Ditizio F, Fahy GT Microscopic polyangitis presenting with sub‑acute reversible optic neuropathy. Eye (Lond.) 2005; 19: 363–365.

8. Nagai Y, Hasegawa M, Igarashi N et al. Cutaneous manifestations and histological features of microscopic polyangiitis. Eur J Dermatol 2008; 19: 57–60.

9. Ozaki S ANCA‑associated vasculitis: diagnostic and therapuetic strategy. Allergo Int 2007; 56: 87–96.

10. Specks U, Merkel PA, Seo P et al. Efficacy of remission‑induction regimens for ANCA‑associated vasculitis. N Engl J Med 2013; 369: 417–427.

11. Haraguchi K, Gunji K, Ito Y et al. Extensive pancreatic necrosis in microscopic polyangiitis. Clin Exp Nephrol 2005; 9: 326–331.

12. Oh YJ, Ahn SS, Park ES et al. Chest and renal involvements, Birmingham vascular activity score more than 13.5 and five factor score more than 1 at diagnosis are significant predictors of relapse of microscopic polyangiitis. Clin Exp Rheumatol 2017; 19: 47–54.

13. Agard C, Mouthon L, Mahr A et al. Microscopic Polyangiitis and Polyarteritis Nodosa: How and When Do They Start? Arthritis & Rheumatism 2003; 15: 709–715.

14. Avery TY, Bons J, van Paassen P et al. Diagnostic ANCA algorithms in daily clinical practice: evidence, experience, and effectiveness. Lupus 2016; 31: 917–924.

15. Veerappan I, Prabitha EN, Abraham A et al. Double ANCA‑positive vasculitis in a patient with infective endocarditis. Indian J Nephrol 2012; 22: 469–472.

16. Langlois V, Marie I Antineutrophil cytoplasmic antibodies associated with infective endocarditis: Literature review. Rev Med Interne 2017; 38: 450-457.

17. Tran H, Tan D, Marnejon TP et al. Cutaneous vasculopathy associated with levamisole‑adulterated cocaine. Clinical Medicine & Research 2013; 11: 26. 30.

18. Yates M, Watts RA, Bajema IM et al. EULAR/ERA‑EDTA recommendations for the management of ANCA‑associated vasculitis. Ann Rheum Dis 2016; 75: 1583–1594.

19. Tesar V, Hruskova Z Avacopan in the treatment of ANCA‑associated vasculitis. Expert Opin Investig Drugs 2018; 27: 491–496.

20. Taha R, El‑Haddad H, Allmualim A et al. Systematic review of the role of rituximab in treatment of antineutrophil cytoplasmic autoantibody‑associated vasculitis, hepatitis C virus‑related cryoglobulinemic vasculitis, Henoch‑Schönlein purpura, ankylosing spondylitis, and Raynaud’s phenomenon. Open Access Rheumatol 2017; 9: 201–214.

21. Jones RB, Hiemstra TF, Ballarin J et al. Mycophenolate mofetil versus cyclophospha‑ mide for remission induction in ANCA‑associated vasculitis: a randomised, non‑inferiority trial. Ann Rheum Dis 2019; 78: 399–405.

22. Cibičková Ľ, Soukup T, Tomš J et al. Centrální pravostranná hemiparéza jako dominující projev systémové vaskulitidy. Vnitř Lék 2010; 56: 1194–1197.

23. Bradna P, Maňák J, Soukup T Difuzní alveolární hemoragie – akutní, život ohrožující stav v revmatologii. Vnitř Lék 2018; 64.