Microscopic polyangiitis: peculiarities of a clinical course and difficulties of diagnostics (case report)
Utkina E.I.1, Myasoedova S.E.1, Manokhin V.Yu.2, Afanasyeva I.P.2, Urusova E.V.2
1 Ivanovo State Medical Academy
2 Ivanovo Regional Clinical Hospital
Microscopic polyangiitis (МРА) is a variant of nodular polyarteritis, which proceeds with the lesion of small vessels, associated with antineutrophil cytoplasmic antibodies (ANCA) to proteinase-3 and myeloperoxidase. The article presents a clinical case of the development of МРА in a woman of 58 years. The patient was hospitalized to the city hospitals many times throughout the year. The disease proceeded with the renal injury by the type of rapidly progressive glomerulonephritis with minimal symptoms from other internal organs and systems. Diagnostic search included: cancer, infections, gynecological, hematological, surgical pathology. Based on the data of laboratory immunological studies — an increase in the ANCA titer to proteinase-3 — a systemic disease was suspected. The diagnosis was confirmed histologically. To achieve control of the process, the use of immunosuppressive therapy was required.
The case illustrates the complexity of timely verification of the diagnosis and the choice of effective treatment in connection with polymorphism of the clinical picture and atypical manifestations of microscopic polyangiitis.
Key words: microscopic polyangiitis, systemic vasculitis, ANCA, fever, immunosuppressive therapy, sclerosing glomerulo-nephritis, kidney biopsy.
For citation: Utkina E.I., Myasoedova S.E., Manokhin V.Yu. et al. Microscopic polyangiitis: peculiarities of a clinical course and difficulties of diagnostics (case report) // RMJ. Medical Review. 2018. № 1(II). P. 118–120.
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