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Published on: August 21, 2017
[Microscopic polyangiitis accompanied by interstitial pneumonia and abducens palsy]
Hideaki Okada1, Yoshirou Mochizuki, Yasuharu Nakahara
1Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center.
Summary
A 69-year-old man with fever and pneumonia was diagnosed with microscopic polyangiitis. Neurological symptoms like diplopia developed later, indicating mononeuritis multiplex.
Area of Science:
- Rheumatology
- Pulmonology
- Neurology
Background:
- Microscopic polyangiitis (MPA) is a rare systemic vasculitis.
- MPA commonly affects the lungs and kidneys.
- Neurological involvement in MPA, such as mononeuritis multiplex, is less common.
Observation:
- A 69-year-old man presented with fever, interstitial pneumonia, and pleural effusion.
- Elevated myeloperoxidase-antineutrophil cytoplasmic antibodies (MPO-ANCA) were detected.
- Lung biopsy revealed usual interstitial pneumonia (UIP)-like histology.
Findings:
- Initial treatment with prednisolone and cyclosporine improved respiratory symptoms.
- The patient later developed diplopia, right abducens palsy, and trigeminal nerve dysfunction.
- Diagnosis of mononeuritis multiplex secondary to microscopic polyangiitis was established.
Implications:
- This case highlights the diverse clinical manifestations of microscopic polyangiitis.
- MPA can present with both pulmonary and neurological involvement.
- Early recognition and management of MPA are crucial to prevent severe complications.
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