一般社団法人日本呼吸器学会 公式サイト
日本呼吸器学会英文誌 Respiratory Investigation
日本呼吸器学会誌 増刊号 学術講演会プログラム 抄録集

Abstract

Full Text of PDF Full Text of PDF (591k)
Article in Japanese

Case Report

A case of sinobronchial syndrome complicated with myeloperoxidase-specific antineutrophil cytoplasmic antibody-related vasculitis

Zen Isobea,b  Shinichi Sasakic  Yasuko Yoshiokac  Shigeru Tominagac  Minami Oriib  Toshitaka Maenob 

aIsobe Clinic
bDepartment of Respiratory Medicine, Gunma University Medical School
cDepartment of Respiratory Medicine, Juntendo Urayasu Hospital

ABSTRACT

A 56 year-old woman, previously diagnosed as having sinobronchial syndrome, presenting bilateral leg muscle weakness and paralysis was admitted to our hospital in April 2005. On admission, she had dyspnea on effort and a fever of 39°C. Her serum titer of MPO-ANCA was positive together with a high titer of BPI-ANCA. Chest CT showed diffuse centrilobular small nodular shadows in both lung fields. Furthermore, a pulmonary function test showed peripheral airway involvement. We diagnosed as diffuse panbronchiolitis (DPB) based on physical examination, positive cold agglutinin reaction, sinusitis, peripheral airway involvement, and radiological finding. On the 19th hospital day, she suddenly had vision impairment. Funduscopy showed multiple white spots on her fundus of the eyes. Muscle biopsy (left quadriceps muscle) revealed that the wall of a small artery and a vein had been infiltrated mainly by lymphocytes. Thus we diagnosed as DPB with MPO-ANCA-related vasculitis. She was treated with methylprednisolone pulse therapy, followed by oral prednisolone. Vasculitis associated with chronic suppurative lung disease has occasionally been reported, suggesting a possible association with chronic bacterial infection, which plays a role in the pathogenesis of ANCA-related vasculitis.

KEYWORDS

Sinobronchial syndrome  Diffuse panbronchiolitis (DPB)  MPO-ANCA-related vasculitis  Antineutrophil cytoplasmic antibody against bactericidal/permeability-increasing protein (BPI-ANCA) 

Received 20 Aug 2013 / Accepted 12 Nov 2013

AJRS, 3(2): 270-275, 2014

Google Scholar