Spontaneous And Protracted Partial Remission Of Microscopic Polyangiitis
Plaisance, M., & Goldsmith, D. J. (2002). spontaneous and protracted partial remission of microscopic polyangiitis. American journal of kidney diseases : the official journal of the National Kidney Foundation, 39(5), 1113–1117. https://doi.org/10.1053/ajkd.2002.32796
View Original Source →Case Details
Disease Location
Kidney
Personal Characteristics
52-year-old woman
Clinical Characteristics
Patient affected by anorexia, vomiting, arthralgias, headache, and skin rash. Creatinine was 2.6 mg/dl; proteinuria, 0.54 g/24 h; and erythrocyte sedimentation rate, 83 mm/h. Urine dipstick showed blood +++ protein++. Slightly positive antinuclear anti- body (ana) but negative anti-dsdna and normal complement levels with positive mpo) p-anca. Diagnosed with mpo- positive anca-associated idiopathic pauci-immune crescentic glomerulonephritis (cgn). Patient remained asymptomatic for 10 years with gradual improvement in renal function. Then, she reported progressive dyspnea. Chest radiograph and computed tomography scan identified a parenchymal infiltrate in the right upper lung. Trans-bronchial biopsy was performed.
Remission Characteristics
Without medical immunosuppression, renal function remained stable for nearly 10 years (although persistent proteinuria, microscopic hematuria, and anti-myeloperoxidase anca antibodies).
Treatment & Mechanisms
Proposed Remission Mechanisms
Not discussed
Clinical Treatment
Nonsteroidal anti-inflammatory drugs for several times a day for 3 weeks and several times a week for some months before diagnosis. Renal biopsy. Transbronchial biopsy. After lung biopsy: oral prednisolone, 20 mg, and cyclophosphamide, 100 mg daily
Non-Clinical Treatment
Homeopathy (arsenical albumin) for several years.