Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Pulmonary Fibrosis with Microscopic Polyangiitis

현미경적 다발혈관염을 동반한 폐섬유증 1예

  • Jeong, Jae-Ho (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kang, Sung-Hee (Department of Diagnostic Pathology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Se-Jung (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Dal-Yong (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Woo-Sung (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Dong-Soon (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Jin-Woo (Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 정재호 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 강성희 (울산대학교 의과대학 서울아산병원 병리학교실) ;
  • 박세정 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 김달용 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 김우성 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 김동순 (울산대학교 의과대학 서울아산병원 호흡기내과학교실) ;
  • 송진우 (울산대학교 의과대학 서울아산병원 호흡기내과학교실)
  • Received : 2010.10.14
  • Accepted : 2011.01.18
  • Published : 2011.03.30
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Abstract

A 65-year-old woman was admitted due to poor oral intake and a dry cough over the previous 3 months. The physical examination was remarkable for bibasilar crackles, and plain chest radiography showed reticulation in both lower lung fields. A pulmonary function test demonstrated a restrictive pattern with a reduced diffusing capacity of the lung for carbon monoxide. High resolution computed tomography showed reticulation and honey-combing in both peripheral lung zones, which was consistent with usual interstitial pneumonia pattern. Her skin showed livedo reticularis. The erythrocyte sedimentation rate and C-reactive protein level were elevated, and hematuria was noted on urinary analysis. A serologic test for auto-antibodies showed seropositivity for Myeloperoxidase-Anti-neutrophil cytoplasmic antibody (MPO-ANCA). A kidney biopsy was performed and showed focal segmental glomerulosclerosis. She was diagnosed as having pulmonary fibrosis with microscopic polyangiitis (MPA) and treated with high dose steroids. Here we report a case of pulmonary fibrosis coexistent with microscopic polyangiitis.

Keywords

References

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