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Microscopic Polyangiitis Presenting with Splenic Infarction: A Case Report
1Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea.
Abstract:
Microscopic polyangiitis (MPA) is an anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The splenic involvement in AAV is known to be rare, and that in MPA has not been reported to date. A 74-year-old woman was admitted owing to left arm numbness and weakness. The patient was diagnosed as MPA with vasculitic neuropathy. Her abdominal computed tomography (CT) revealed splenic infarction incidentally. The splenic infarction had been resolved at follow-up CT after treatment. If splenic involvement of MPA was not considered, treatment may have been delayed in order to differentiate other diseases. Herein, I report the first case of splenic involvement of MPA.
Insights
Microscopic polyangiitis (MPA), a form of ANCA-associated vasculitis, rarely affects the spleen. This report details the first documented case of splenic infarction in MPA, highlighting its potential diagnostic implications.
Area of Science:
- Medicine
- Rheumatology
- Immunology
Background:
- Microscopic polyangiitis (MPA) is a rare anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).
- Splenic involvement is uncommon in AAV and has not been previously reported in MPA.
- Early diagnosis and treatment are crucial for managing AAV to prevent organ damage.
Observation:
- A 74-year-old woman presented with left arm numbness and weakness.
- She was diagnosed with MPA and vasculitic neuropathy.
- Abdominal CT incidentally revealed splenic infarction, which resolved after treatment.
Findings:
- This case represents the first documented instance of splenic involvement in MPA.
- The splenic infarction was an incidental finding during the diagnostic workup for MPA symptoms.
- Resolution of splenic infarction was observed following appropriate MPA treatment.
Implications:
- Recognizing splenic involvement in MPA is critical for accurate diagnosis and timely treatment.
- Considering rare organ involvement can prevent diagnostic delays and improve patient outcomes.
- This finding expands the spectrum of known AAV manifestations and emphasizes the need for comprehensive evaluation.
