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Extracorporeal membrane oxygenation for pulmonary hemorrhage in microscopic polyangiitis

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Chinese Medical Journal 2008年第24期121卷 2622-2623页

作者： ZHONG Hua CHEN Ji-hua LI Sai-qi JIANG Li-yan LI Xin HAN Bao-hui Department of Pulmonology Shanghai Chest Hospital Shanghai 200127 China

microscopic polyangiitis （MPA） is characterized by an inflammatory process of the vessel walls and is classified according to the smallest vessels involved. Diagnosis is based on clinical manifestations, anti-neutrophil cytoplasmic autoantibody （ANCA） testing, and histology. In this disease, pulmonary hemorrhage is seen in 30% of patients and is associated with an eight-fold increase in mortality. Classically, MPA involves the kidneys and upper and lower respiratory tracts. Due to the perceived risk of increased bleeding secondary to the use of systemic anticoagulation, extra corporeal membrane oxygenation （ECMO） is often not used to treat patients with hemorrhage suffered from MPA. Here we report a case of a 50-year-old woman with MPA that was successfully supported with ECMO.

关键词： microscopic polyangiitis pulmonary hemorrhage

Prognosis of microscopic polyangiitis with renal involvement:report of 60 Chinese patients

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Chinese Medical Journal 2005年第24期118卷 2089-2092页

作者： HU Wei-xin, LIU Zhi-hong,LIU Chun-bei,TANG Zheng, WANG Qing-wen, CHEN Hui-ping and LI Lei-shi Department of Nephrology, Clinical School of Nan jing, Second Military Medical University Research Institute of Nephrology, Jinling Hospital, Nanjing 210002, China Department of Nephrology Clinical School of Nanjing Second Military Medical University

With the widespread clinical application of renal biopsy and serum antineutrophil cytoplasmicantibody （ANCA） testing, the percentage of renal injuries caused by systemic small vessel vasculitis （ SVV ） including microscopic polyangiitis （ MPA ） and Wegener＇ s granulomatosis （WG） is on the rise in China. According to our previous report, SVV constituted 1.09% of diagnoses from all renal biopsies （5. 8% in secondary nephritis） and 14.4% of that from renal biopsies from patients with chronic renal failure,

关键词： microscopic polyangiitis antineutrophil cytoplasmic antibody outcome, survival

Characteristics and Prognosis of microscopic polyangiitis Patients with Diffuse Alveolar Hemorrhage and Interstitial Lung Disease

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Chinese Medical Sciences Journal 2022年第4期37卷 293-302页

作者： Yu Gu Ting Zhang Min Peng Juhong Shi Department of Respiratory and Critical Care Medicine Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100037China

Objective To evaluate the clinical characteristics and prognostic predictors of patients with diffuse alveolar hemorrhage(DAH)and/or interstitial lung disease(ILD)secondary to microscopic polyangiitis(MPA)in a Chinese general *** We retrospectively reviewed the medical records of MPA patients admitted to internal medicine departments between the year 2002 and *** patients were divided into the ILD,DAH,DAH combined with ILD(DAHILD),and no pulmonary involvement(NPI)groups according to pulmonary involvement *** clinical characteristics at diagnosis were *** risk factors associated with short-term death and long-term death were identified with Logistic regression and Cox *** Of 193 newly diagnosed MPA patients,181 patients were enrolled in the research,of which 19 had DAH alone,96 had ILD alone,18 had DAH and DAH concurrently,and 48 had *** median of serum creatine level in the DAH group was 449μmol/L,significantly higher than that in the ILD group(123μmol/L,Nemenyi=-35.215,P=0.045)and DAHILD group(359μmol/L,Nemenyi=-43.609,P=0.007).The median follow-up time was 67(range:1-199)*** in the ILD group were older than those in the DAH group(median:69 years vs.57 years,Nemenyi=43.853,P=0.005).The patients with both DAH and ILD had combined features of the two subtypes,and the highest mortality(72.2%at the end of follow-up).The elevated white blood cell count was a risk factor for short-term death(OR=1.103,95%CI:1.008-1.207,P=0.032 for one month;OR=1.103,95%CI:1.026-1.186,P=0.008 for one year).Old age(HR=1.044,95%CI:1.023-1.066,P<0.001),cardiovascular system involvement(HR=2.093,95%CI:1.195-3.665,P=0.010),poor renal function(HR=1.001,95%CI:1.000-1.002,P=0.032)were risk factors for long-term *** infections(38/54)were the leading causes of death,especially for the patients with ***,49 patients suffered from pulmonary infections in the first year after *** MPA patients who prese

关键词： microscopic polyangiitis diffuse alveolar hemorrhage interstitial lung disease mortality risk factors

rare type of pancreatitis as the first presentation ofanti-neutrophil cytoplasmic antibody-related vasculitis

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World Journal of Gastroenterology 2016年第7期22卷 2383-2390页

作者： Tomoya Iida Takeya Adachi Tetsuya Tabeya Suguru Nakagaki Takashi Yabana Akira Goto Yoshihiro Kondo Kiyoshi Kasai Department of Gastroenterology Otaru City General HospitalOtaruHokkaido 047-8550Japan Department of Internal Medicine of Connective Tissue Disease Otaru City General HospitalOtaruHokkaido 047-8550Japan Department of Diagnostic Pathology Otaru City General HospitalOtaruHokkaido 047-8550Japan

A pancreatic tumor was suspected on the abdominal ultrasound of a 72-year-old man. Abdominal computed tomography showed pancreatic enlargement as well as a diffuse, poorly enhanced area in the pancreas; endoscopic ultrasound-guided fine needle aspiration biopsy and endoscopic retrograde cholangiopancreatography failed to provide a definitive diagnosis. Based on the trend of improvement of the pancreatic enlargement, the treatment plan involved follow-up examinations. Later, he was hospitalized with an alveolar hemorrhage and rapidly progressive glomerulonephritis; he tested positive for myeloperoxidase-anti-neutrophil cytoplasmic antibody(ANCA) and was diagnosed with ANCArelated vasculitis, specifically microscopic polyangiitis. It appears that factors such as thrombus formation caused by the vasculitis in the early stages of ANCArelated vasculitis cause abnormal distribution of the pancreatic blood flow, resulting in non-uniform pancreatitis. Pancreatic lesions in ANCA-related vasculitis are very rare. Only a few cases have been reported previously. Therefore, we report our case and a review of the literature.

关键词： Pancreas Pancreatitis Antibodies Antineutrophil cytoplasmic Vasculitis microscopic polyangiitis

Urological manifestations and treatment of the primary systemic vasculitides

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World Journal of Clinical Urology 2015年第1期4卷 5-20页

作者： Javeria Peracha Matthew David Morgan School of Immunity and Infection College of Medical and Dental Sciences University of Birmingham Centre for Translational Inflammation Research University of Birmingham Research LaboratoriesQueen Elizabeth Hospital Birmingham

The primary systemic vasculitides(PSV) are a group of rare inflammatory disorders affecting blood vessels of varying size and multiple organs. Urological manifestations of PSV are uncommon. Testicular vasculitis is the most commonly reported finding and is associated with Polyarteritis Nodosa(PAN), Henoch-Sch?nleinPurpura(HSP), anti-neutrophil cytoplasm antibody associated Vasculitides(AAV), Giant Cell Arteritis(GCA) and Kawasaki disease. Prostatic vasculitis has been reported in association with GCA and AAV. Ureteric involvement has been noted in PAN, HSP and AAV. Other urogenital manifestations of PSV include genital ulceration and bladder dysfunction in Beh?ets Disease and haematuria which is commonly seen in many of the PSV. Finally, therapies used to treat the PSV, especially cyclophosphamide, are associated with urological sideeffects including haemorrhagic cystitis and urothelial malignancy. The aim of this review is to examine how the urological system is involved in the PSV. Each PSV is examined in turn, with a brief clinical description of the disease followed by a description of the urological manifestations and management. Identification of urological manifestations of PSV is important as in many cases symptoms may improve with immunosuppressive therapy, avoiding the need for invasive surgery. Additionally, patients who present with isolated urogenital PSV are at higher risk of developing subsequent systemic vasculitis and will need to be followed up closely.

关键词： Urology Vasculitis Takayasu arteritis Giant cell arteritis Polyarteritis Nodosa Kawasaki disease Henoch-Schonlein Purpura Anti-neutrophil cytoplasm antibody associated vasculitides Granulomatosis with polyangiitis microscopic polyangiitis Behcets disease Eosinophilic granulomatosis with polyangiitis Epididymo-orchitis Prostatitis Ureteric stenosis

Olfactory dysfunction in antineutrophil cytoplasmic antibodyassociated vasculitides: A review of the literature

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World Journal of Methodology 2021年第2期11卷 15-22页

作者： Alfonso Luca Pendolino Anika Kaura Annakan V Navaratnam Monica Pendolino Gerolamo Bianchi Samit Unadkat Giancarlo Ottaviano Premjit S Randhawa Peter J Andrews Department of Ear Nose and ThroatRoyal National ENT and Eastman Dental HospitalsLondon WC1E 6DGUnited Kingdom Ear Institute University College LondonLondon WC1X 8EEUnited Kingdom Division of Rheumatology Department of Locomotor SystemASL 3Genoa 16121Italy Department of Neurosciences DNS Otolaryngology SectionUniversity of PaduaPadua 35128Italy

Olfactory dysfunction(OD)has been described in patients with antineutrophil cytoplasmic antibody-associated vasculitides(AAV),but the underlying mechanisms are not completely *** causes of altered smell function can generally be divided into conductive,sensorineural or *** date no specific treatment is available for AAV-related OD and the efficacy of currently available options has not been *** aim of this review is to provide an overview of the causes that may lead to OD in patients with *** available treatments for OD and possible options in patients with AAV presenting with smell impairment are also mentioned.

关键词： Smell Olfactory dysfunction Antineutrophil cytoplasmic antibody-associated vasculitis diseases Granulomatosis with polyangiitis Eosinophilic granulomatosis with polyangiitis microscopic polyangiitis