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Onset of Microscopic Polyangiitis in Binephrectomied Patient on Chronic Hemodialysis—Case Report

INTRODUCTION: Microscopic polyangiitis (MPA) is one of the causes of the pulmonary–renal syndrome associated with elevated non-specific markers of inflammation and antineutrophil cytoplasmic autoantibody (ANCA) positivity in 50–75%. De novo occurrence of the disease in patients on chronic hemodialys...

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Detalles Bibliográficos
Autores principales: Jankovic, Aleksandar, Maslarevic-Radovic, Vesna, Djuric, Petar, Tosic-Dragovic, Jelena, Bulatovic, Ana, Simovic, Nikola, Mitrovic, Milos, Stankovic-Popovic, Verica, Dopudja-Pantic, Vesna, Arandjelovic, Snezana, Dimkovic, Nada
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303727/
https://www.ncbi.nlm.nih.gov/pubmed/28243232
http://dx.doi.org/10.3389/fimmu.2017.00111
Descripción
Sumario:INTRODUCTION: Microscopic polyangiitis (MPA) is one of the causes of the pulmonary–renal syndrome associated with elevated non-specific markers of inflammation and antineutrophil cytoplasmic autoantibody (ANCA) positivity in 50–75%. De novo occurrence of the disease in patients on chronic hemodialysis (HD) has not been described. CASE PRESENTATION: We presented patient who developed MPO-ANCA-associated MPA with lung and musculoskeletal involvement after 4 years on regular HD due to bilateral nephrectomy. After excluding the other causes of MPO-ANCA positivity, diagnosis was confirmed even without renal biopsy. Patient received standard immunosuppression therapy and he is still in remission after 27 months. CONCLUSION: The onset of immune-mediated disease could be observed even after introduction of renal replacement therapy, which may be a diagnostic problem. Early recognition and traditional immunosuppressive regiment may provide successful outcome.