Full Text of PDF (714k)
Article in Japanese
Abstract
Case Report
A patient with Goodpasture's syndrome positive for myeloperoxidase-antineutrophil cytoplasmic antibody successfully treated with steroid therapy
Mitsuhiro Abea Akira Sudaa Tadashi Yoshidaa Takashi Urushibaraa,b Hajime Kasaia,b Toshihide Shinozakia
aDepartment of Respiratory Medicine, Kimitsu Chuo Hospital
bDepartment of Respirology, Graduate School of Medicine, Chiba University
ABSTRACT
A 64-year-old woman who has untreated rheumatoid arthritis was admitted to our hospital because of severe renal failure, anemia, and respiratory failure. Because the patient developed pulmonary hemorrhage and rapidly progressive glomerulonephritis and was positive for antiglomerular basement membrane antibody, Goodpasture's syndrome was diagnosed. She was also positive for myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA). Immediately after admission, continuous hemodiafiltration was started for renal failure. Although rapidly progressing respiratory failure required systemic management using artificial ventilation on the second hospital day, she was saved by steroid administration alone without the use of immunosuppressive agents or plasma exchange therapy. Renal death was inevitable because of severe Goodpasture's syndrome positive for MPO-ANCA, but the patient's survival was successfully achieved only by the use of steroid therapy.
KEYWORDS
Steroid pulse therapy Anti-glomerular basement membrane antibodies Goodpasture's syndrome Myeloperoxidase-antineutrophil cytoplasmic antibody
Received 13 Jan 2012 ／ Accepted 6 Jun 2012
AJRS, 2(1): 18-23, 2013
Copyright © The Japanese Respiratory Society All Rights Reserved.