Microscopic polyangiitis initiated with liver dysfunction, calf pain and fever of unknown origin.

Abstract

We report herein a case of microscopic polyangiitis (MPA), presenting onset with a spiking fever, liver/biliary dysfunction without jaundice and calf pain without elevation of serum creatine phosphokinase. During 1 month of careful examinations for initial diagnosis, the patient developed renal dysfunction and pulmonary hemorrhage. Based on the results of positive MPO-ANCA, renal and pulmonary involvements, the patient was diagnosed with MPA and treated with high-dose prednisolone and oral cyclophosphamide. Soon after initiation of the treatment, symptoms such as fever, calf pain, liver/biliary dysfunction and renal dysfunction disappeared with decrease of MPO-ANCA titer to the normal level.

• Authors: Kei Ohnuma, Osamu Hosono, Tomoki Katayose, Noritada Yoshikawa, Hiroshi Kawasaki, Takeshi Fujii, Naoki Oyaizu, Hirotoshi Tanaka, Chikao Morimoto
• Journal: Rheumatology international (Rheumatol Int) Vol. 30 Issue 12 Pg. 1651-6 (Nov 2010) ISSN: 1437-160X [Electronic] Germany
• PMID: 19774384 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Antineutrophil Cytoplasmic
• Cyclophosphamide
• Prednisolone
• Peroxidase

Topics

• Administration, Oral
• Antibodies, Antineutrophil Cytoplasmic (blood, immunology)
• Cyclophosphamide (therapeutic use)
• Dose-Response Relationship, Drug
• Female
• Fever of Unknown Origin (drug therapy, etiology, pathology)
• Humans
• Leg
• Liver Diseases (complications, pathology)
• Microscopic Polyangiitis (diagnosis, drug therapy, etiology)
• Middle Aged
• Pain (drug therapy, etiology, pathology)
• Peroxidase (blood, immunology)
• Prednisolone (therapeutic use)
• Treatment Outcome