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Mixed connective tissue disease developing into MPO-ANCA-positive polyangiitis
Taichi Murakami1, Shuichiro Endo, Toshiaki Moriki
1Department of Nephrology, Tokushima University Hospital, Japan. tatsunoya@clin.med.tokushima-u.ac.jp
Internal Medicine (Tokyo, Japan)
|March 23, 2011
Summary
Mixed connective tissue disease (MCTD) can present with kidney disease mimicking lupus. This case highlights a rare concurrent MPO-ANCA-related glomerulonephritis in an elderly patient with MCTD.
Area of Science:
- Nephrology
- Rheumatology
- Immunology
Background:
- Mixed connective tissue disease (MCTD) typically involves immune complex glomerulonephritis similar to systemic lupus erythematosus (SLE).
- Renal involvement in MCTD generally carries a good prognosis.
Observation:
- An elderly female patient with MCTD presented with autoimmune pleurisy and rapidly progressive glomerulonephritis.
- Laboratory tests revealed positive myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) at 59.0 EU, with normal anti-DNA antibody and complement levels.
Findings:
- Renal biopsy showed crescentic glomerulonephritis and mild mesangial proliferation.
- Immunofluorescence confirmed immune-complex glomerulonephritis.
- These results suggest a concurrent development of MPO-ANCA-related glomerulonephritis alongside MCTD renal involvement.
Implications:
- This case expands the understanding of renal manifestations in MCTD.
- It highlights the importance of considering MPO-ANCA-related glomerulonephritis in MCTD patients with rapidly progressive kidney disease.
- The concurrent presence of these conditions may influence patient prognosis and treatment strategies.
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