Antineutrophil Cytoplasmic Antibody-associated Vasculitis Involving Diffuse Alveolar Hemorrhage, Rapidly Progressive Glomerulonephritis and Hypereosinophilia

Hirofumi Kamata; Hidefumi Koh; Yasuhiro Okubo; Hiroyoshi Kunimoto; Atsushi Chiyotani; Koichi Sayama; Naoki Hasegawa; Makio Mukai

doi:10.2169/internalmedicine.52.0481

CASE REPORTS

Antineutrophil Cytoplasmic Antibody-associated Vasculitis Involving Diffuse Alveolar Hemorrhage, Rapidly Progressive Glomerulonephritis and Hypereosinophilia

Hirofumi Kamata, Hidefumi Koh, Yasuhiro Okubo, Hiroyoshi Kunimoto, Atsushi Chiyotani, Koichi Sayama, Naoki Hasegawa, Makio Mukai

Author information

Hirofumi Kamata
Division of Pulmonary Medicine, Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Japan
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
Hidefumi Koh
Division of Pulmonary Medicine, Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Japan
Yasuhiro Okubo
Division of Nephrology, Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Japan
Hiroyoshi Kunimoto
Division of Pulmonary Medicine, Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Japan
Atsushi Chiyotani
Division of Pulmonary Medicine, Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Japan
Koichi Sayama
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
Naoki Hasegawa
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Japan
Makio Mukai
Department of Pathology, Keio University School of Medicine, Japan

Keywords: ANCA-associated vasculitis, rapidly progressive glomerulonephritis, diffuse alveolar hemorrhage, hypereosinophilia

JOURNAL OPEN ACCESS

2013 Volume 52 Issue 19 Pages 2253-2257

DOI https://doi.org/10.2169/internalmedicine.52.0481

Details

Abstract

The classification of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) has limitations because the condition includes disorders with similar general clinical features, similar characteristics of lung and renal involvement and a positive ANCA serology. A 40-year-old woman was admitted to our hospital for hemoptysis and dyspnea. She had no history of bronchial asthma. Laboratory examinations revealed hypereosinophilia, positive anti-myeloperoxidase antibodies, hematuria and proteinuria. The patient was ultimately diagnosed with AAV associated with diffuse alveolar hemorrhage, rapidly progressive glomerulonephritis and hypereosinophilia without bronchial asthma. Obtaining a definitive diagnosis of ANCA vasculitis can be very difficult, and the characteristics of this case were not compatible with the findings of typical AVV. We herein report a rare case of AVV.

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