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Microscopic Polyangiitis Presenting with Splenic Infarction: A Case Report.

Sang Wan Chung1

  • 1Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea.

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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.

Keywords:
ANCA-associated vasculitisMPAsplenic infarction

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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.