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Microscopic polyangiitis presented with biopsy-confirmed pleuritis

Naoto Ishimaru, Hisashi Ohnishi, Mao Fujii, Masako Yumura, Sho Yoshimura, Saori Kinami
  • Naoto Ishimaru
    Akashi Medical Center, Department of General Internal Medicine, Japan | maru-tkb@umin.ac.jp
  • Hisashi Ohnishi
    Akashi Medical Center, Department of Respiratory Medicine, Japan
  • Mao Fujii
    Akashi Medical Center, Department of Respiratory Medicine, Japan
  • Masako Yumura
    Akashi Medical Center, Department of Respiratory Medicine, Japan
  • Sho Yoshimura
    Akashi Medical Center, Department of Respiratory Medicine, Japan
  • Saori Kinami
    Akashi Medical Center, Department of General Internal Medicine, Japan

Abstract

We describe a case of microscopic polyangiitis manifested as pleuritis confirmed by thoracoscopic biopsy. An 80-year-old man presented with a three-day history of shortness of breath and cough. Chest radiography revealed patchy opacities in the lower fields of the bilateral lung and right-sided pleural effusion. Thoracentesis revealed lymphocytic pleural exudates. Thoracoscopic biopsy specimens were compatible with fibrotic pleuritis. He developed rapidly progressive glomerulonephritis with elevated myeloperoxidase anti-neutrophil cytoplasmic antibody titer in blood and pleural effusion. Although the patient was resistant to two weekly courses of pulse steroid therapy, he was successfully treated with a five-day course of intravenous immunoglobulin.

Keywords

Microscopic polyangiitis; pleuritis; thoracoscopy.

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Submitted: 2017-11-08 23:15:10
Published: 2018-06-21 13:39:12
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Copyright (c) 2018 Naoto Ishimaru, Hisashi Ohnishi, Mao Fujii, Masako Yumura, Sho Yoshimura, Saori Kinami

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