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[Diffuse panbronchiolitis with P-ANCA-positive arteritis and necrotizing glomerulitis]

N Saku1, Y Sugiyama, S Kitamura

  • 1Department of Pulmonary Medicine and Pathology, Jichi Medical School, Tochigi, Japan.

Nihon Kyobu Shikkan Gakkai Zasshi
|April 1, 1996
PubMed
Summary

Diffuse panbronchiolitis may lead to ANCA-associated vasculitis. This case highlights how chronic lung infection can trigger autoimmune responses, causing systemic inflammation and organ damage.

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Area of Science:

  • Pulmonology
  • Nephrology
  • Rheumatology

Background:

  • Diffuse panbronchiolitis is a chronic inflammatory lung disease.
  • Erythromycin treatment improved symptoms and radiographic findings in this patient.
  • The patient presented with fever, skin eruption, and diplopia.

Observation:

  • Lung biopsy revealed arteritis with medial destruction of peribronchial arteries.
  • Renal biopsy showed periglomerular granulomatous inflammation and necrotizing glomerulitis.
  • The patient tested positive for perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA).

Findings:

  • Cytoplasmic ANCA testing, specific for Wegener's granulomatosis, was negative.
  • The findings suggest a potential link between chronic pulmonary infection and ANCA formation.

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  • The patient's vasculitis may be secondary to ANCA induced by diffuse panbronchiolitis.

    • Implications:

    • Chronic pulmonary infections can precipitate autoimmune vasculitis.
    • Understanding this association is crucial for diagnosing and managing complex cases.
    • Further research is needed to elucidate the mechanisms linking diffuse panbronchiolitis and ANCA-associated vasculitis.