Skip to main content
Top
Published in: Rheumatology International 3/2009

01-01-2009 | Case Report

A case of limited systemic sclerosis with p-ANCA, complicated by multiple cerebral hemorrhages

Authors: Bharath Manu Akkara Veetil, Barry M. Schimmer

Published in: Rheumatology International | Issue 3/2009

Login to get access

Abstract

ANCA associated vasculitides are a group of disorders characterized by the presence of necrotizing inflammation of blood vessels that involve venules, capillaries, arterioles, arteries, and veins. They are characterized by the presence of antineutrophil cytoplasmic antibodies (ANCA). ANCA associated vasculitis commonly affects the kidney producing proteinuria, hematuria and variable degrees of renal failure. Other organs involved include the lung, skin and peripheral nervous system. We present a patient with limited systemic sclerosis, who later developed pauci-immune glomerulonephritis with p-ANCA (antimyeloperoxidase) specificity and, whose disease was later complicated by cerebral vasculitis with multiple intracerebral hemorrhages.
Literature
1.
go back to reference Jennette JC (1991) Antineutrophil cytoplasmic autoantibody-associated diseases: a pathologist’s perspective. Am J Kidney Dis 18:164–170PubMed Jennette JC (1991) Antineutrophil cytoplasmic autoantibody-associated diseases: a pathologist’s perspective. Am J Kidney Dis 18:164–170PubMed
2.
3.
go back to reference Falk RJ, Jennette JC (2002) ANCA are pathogenic–oh yes they are! J Am Soc Nephrol 13:1977–1979PubMed Falk RJ, Jennette JC (2002) ANCA are pathogenic–oh yes they are! J Am Soc Nephrol 13:1977–1979PubMed
5.
go back to reference Jennette JC, Thomas DB, Falk RJ (2001) Microscopic polyangiitis (microscopic polyarteritis). Semin Diagn Pathol 18:3–13PubMed Jennette JC, Thomas DB, Falk RJ (2001) Microscopic polyangiitis (microscopic polyarteritis). Semin Diagn Pathol 18:3–13PubMed
6.
go back to reference Endo H, Hosono T, Kondo H (1994) Antineutrophil cytoplasmic autoantibodies in 6 patients with renal failure and systemic sclerosis. J Rheumatol 21:864–870PubMed Endo H, Hosono T, Kondo H (1994) Antineutrophil cytoplasmic autoantibodies in 6 patients with renal failure and systemic sclerosis. J Rheumatol 21:864–870PubMed
7.
go back to reference Locke IC, Worrall JG, Leaker B, Black CM, Cambridge G (1997) Autoantibodies to myeloperoxidase in systemic sclerosis. J Rheumatol 24:86–89PubMed Locke IC, Worrall JG, Leaker B, Black CM, Cambridge G (1997) Autoantibodies to myeloperoxidase in systemic sclerosis. J Rheumatol 24:86–89PubMed
8.
go back to reference Wutzl AL, Foley RN, O’Driscoll BR, Reeve RS, Chisholm R, Herrick AL (2001) Microscopic polyangiitis presenting as pulmonary-renal syndrome in a patient with long-standing diffuse cutaneous systemic sclerosis and antibodies to myeloperoxidase. Arthritis Rheum 45:533–536. doi :10.1002/1529-0131(200112)45:6<533::AID-ART379>3.0.CO;2-DPubMedCrossRef Wutzl AL, Foley RN, O’Driscoll BR, Reeve RS, Chisholm R, Herrick AL (2001) Microscopic polyangiitis presenting as pulmonary-renal syndrome in a patient with long-standing diffuse cutaneous systemic sclerosis and antibodies to myeloperoxidase. Arthritis Rheum 45:533–536. doi :10.1002/1529-0131(200112)45:6<533::AID-ART379>3.0.CO;2-DPubMedCrossRef
12.
go back to reference Sasaki A, Hirato J, Nakazato Y, Tanaka T, Takeuchi H (1998) An autopsy case of P-ANCA-positive microscopic polyangiitis with multiple cerebral hemorrhagic infarction. No To Shinkei 50:56–60PubMed Sasaki A, Hirato J, Nakazato Y, Tanaka T, Takeuchi H (1998) An autopsy case of P-ANCA-positive microscopic polyangiitis with multiple cerebral hemorrhagic infarction. No To Shinkei 50:56–60PubMed
13.
go back to reference Honda H, Hasegawa T, Morokawa N, Kato N, Inoue K (1996) A case of MPO-ANCA related vasculitis with transient leukoencephalopathy and multiple cerebral hemorrhage. Rinsho Shinkeigaku 36:1089–1094PubMed Honda H, Hasegawa T, Morokawa N, Kato N, Inoue K (1996) A case of MPO-ANCA related vasculitis with transient leukoencephalopathy and multiple cerebral hemorrhage. Rinsho Shinkeigaku 36:1089–1094PubMed
14.
go back to reference Ito Y, Suzuki K, Yamazaki T, Yoshizawa T, Ohkoshi N, Matsumura A (2006) ANCA-associated vasculitis (AAV) causing bilateral cerebral infarction and subsequent intracerebral hemorrhage without renal and respiratory dysfunction. J Neurol Sci 240:99–101. doi:10.1016/j.jns.2005.07.003 PubMedCrossRef Ito Y, Suzuki K, Yamazaki T, Yoshizawa T, Ohkoshi N, Matsumura A (2006) ANCA-associated vasculitis (AAV) causing bilateral cerebral infarction and subsequent intracerebral hemorrhage without renal and respiratory dysfunction. J Neurol Sci 240:99–101. doi:10.​1016/​j.​jns.​2005.​07.​003 PubMedCrossRef
19.
go back to reference Nachman PH, Hogan SL, Jennette JC, Falk RJ (1996) Treatment response and relapse in antineutrophil cytoplasmic autoantibody-associated microscopic polyangiitis and glomerulonephritis. J Am Soc Nephrol 7:33–39PubMed Nachman PH, Hogan SL, Jennette JC, Falk RJ (1996) Treatment response and relapse in antineutrophil cytoplasmic autoantibody-associated microscopic polyangiitis and glomerulonephritis. J Am Soc Nephrol 7:33–39PubMed
Metadata
Title
A case of limited systemic sclerosis with p-ANCA, complicated by multiple cerebral hemorrhages
Authors
Bharath Manu Akkara Veetil
Barry M. Schimmer
Publication date
01-01-2009
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 3/2009
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-008-0675-8

Other articles of this Issue 3/2009

Rheumatology International 3/2009 Go to the issue