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[Pulmonary involvement in patients with myeloperoxidase specific-antineutrophil cytoplasmic antibody]
Y Arimura1, S Minoshima, U Tanaka
1First Department of Internal Medicine, Kyorin University, School of Medicine, Tokyo.
Abstract:
In order to examine the clinical features of pulmonary involvement in patients with myeloperoxidase specific-antineutrophil cytoplasmic antibody (MPO-ANCA), 46 MPO-ANCA positive patients with collagen-vascular disease and glomerulonephritis were investigated. Twenty eight patients (60.8%) had pulmonary involvement without tumor and infection, 20 (43.5%) of MPO-ANCA positive patients had interstitial pneumonitis, 11 (23.9%) had pulmonary hemorrhage, 3 had asthma (6.5%) and 7 had both interstitial pneumonitis and pulmonary hemorrhage. Patients with pulmonary involvement were older (mean age 61.1) and they had higher inflammatory acute phase reactants and higher mortality (42.9%) than patients without pulmonary involvement. Pulmonary hemorrhage revealed on both lung fields in 10 patients, 7 patients required artificial respirator and 6 died. Titer of MPO-ANCA increased paralleled with progression of pulmonary hemorrhage. Interstitial fibrosis revealed predominantly lower and lateral side of the lung. It is suggested that MPO-ANCA may be closely related to the pathogenesis of pulmonary hemorrhage and interstitial pneumonia. Careful management is needed in patients with pulmonary involvement, especially pulmonary hemorrhage in patients with MPO-ANCA.
Insights
Myeloperoxidase-specific antineutrophil cytoplasmic antibody (MPO-ANCA) is linked to lung issues like interstitial pneumonia and pulmonary hemorrhage. Higher MPO-ANCA levels correlate with severe pulmonary hemorrhage, indicating a need for careful patient management.
Area of Science:
- Rheumatology
- Pulmonology
- Immunology
Context:
- Investigated clinical features of pulmonary involvement in MPO-ANCA positive patients.
- Included 46 patients with collagen-vascular disease and glomerulonephritis.
Purpose:
- To examine the clinical features of pulmonary involvement in MPO-ANCA positive patients.
- To understand the relationship between MPO-ANCA and lung diseases.
Summary:
- 60.8% of MPO-ANCA positive patients had pulmonary involvement (interstitial pneumonitis, pulmonary hemorrhage, asthma).
- Pulmonary involvement was associated with older age, higher inflammatory markers, and increased mortality.
- MPO-ANCA titers correlated with pulmonary hemorrhage progression, suggesting a role in pathogenesis.
Impact:
- Highlights MPO-ANCA's association with interstitial pneumonia and pulmonary hemorrhage.
- Emphasizes the need for careful management of MPO-ANCA patients with pulmonary involvement, especially hemorrhage.
- Suggests MPO-ANCA's potential role in the pathogenesis of these lung conditions.