Occult microscopic polyangiitis presenting as pyrexia of unknown origin

Ziaj, Stela; Mitchell, C; Roufosse, Candice; Sw, Dubrey

doi:10.12968/hmed.2014.75.3.172

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…Regarding fever, two retrospective studies reported that approximately 40% of MPA patients presented with fever [4,5], with a more recent study in China reporting that nearly 90% of their MPA patients presenting with pulmonary brosis had a fever [6]. Moreover, the published cases of FUO as a feature of MPA exhibit distinct clinical manifestations and organ involvements [7][8][9][10][11][12][13], thus the heterogeneity in the clinical presentation makes early diagnosis more challenging.…”

Section: Discussionmentioning

confidence: 99%

A Critical Case of MPO-ANCA-Associated Vasculitis with an Initial Presentation of Fever of Unknown Origin

Teng,

Wu,

Chuang

et al. 2024

Preprint

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Microscopic polyangiitis (MPA) is a multisystem small vessel necrotising vasculitis which can present with various clinical manifestations. The disease is classically associated with perinuclear anti-neutrophil cytoplasmic antibodies (ANCA) that target the antigen myeloperoxidase (MPO). Herein, we report the case of a 72-year-old male with microscopic polyangiitis who presented with a fever of unknown origin (FUO) 1 month before admission. The patient developed renal dysfunction, pulmonary oedema and respiratory distress attributed to endotracheal intubation and admission to the intensive care unit. The patient had elevated serum creatinine levels and was positive for MPO-ANCA, so a renal biopsy was performed. The pathological diagnosis was consistent with pauci-immune crescentic glomerulonephritis and the patient was treated with pulse steroid and cyclophosphamide therapy in conjunction with plasma exchange. The patient was extubated in 7 days with a satisfactory urine output and stable serum creatinine. This article reports a case of MPA with a critical illness that initially presented as an FUO and was resolved quickly after treatment initiation.

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Section: Discussionmentioning

confidence: 99%

A Critical Case of MPO-ANCA-Associated Vasculitis with an Initial Presentation of Fever of Unknown Origin

Teng,

Wu,

Chuang

et al. 2024

Preprint

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“…Also, severe co-trimoxazole-induced hypoglycaemia, crescentic glomerulonephritis, acute cervical myelitis, and acute cholecystitis have been observed in patient with MPA [70][71][72][73]. Indeed, ruptured gastric artery aneurysm, hemorrhagic stroke, pyrexia of unknown origin, lymphoma, bilateral brachial plexopathy, intraventricular hemorrhage, and pneumomediastinum are recognizesd as the uncommon manifestations and complications of MPA [66,[72][73][74][75]77]. Meanwhile, patients with MPA are at risk for developing venous thromboembolic events (VTE) and eye involvement [78,79].…”

Section: Mpa Clinical Features and Management: A New Progressmentioning

confidence: 99%

ANCA-Associated Vasculitis: Advancement in Pathogenesis, Clinical Features and Management

Azab

Safi

Wang

2019

BJSTR

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Anti-Neutrophil Cytoplasmic Autoantibody (ANCA)-Associated Vasculitides (AAVs) are rare disorders characterized by inflammation of the small blood vessels resulting in ischemia or haemorrhage. The main phenotypes of AAVs are Granulomatosis with Polyangiitis (GPA), Microscopic Polyangiitis (MPA), and Eosinophilic Granulomatosis with Polyangiitis (EGPA). Although the pathogenesis of these disorders is still incompletely understood, distinct roles for T cells subsets and ANCA autoantibodies were underscored. AAVs present in the head, neck, lung, kidney, skin, heart, eyes, and intestine. The treatment of AAVs aims to induce and maintain remission and rapidly control of the disease activity. Rituximab, the first major alternative to cyclophosphamide plus glucocorticoids therapy, has enhanced the management of AAVs. However, continuous evaluation is constantly needed to manage the uncommon clinical features which may accompany the disease. This review summarizes the major findings of recent studies related to the three kinds of AAVs focusing on new novelties of their pathogenesis, clinical manifestations, and management.

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Occult microscopic polyangiitis presenting as pyrexia of unknown origin

Cited by 2 publications

References 6 publications

A Critical Case of MPO-ANCA-Associated Vasculitis with an Initial Presentation of Fever of Unknown Origin

A Critical Case of MPO-ANCA-Associated Vasculitis with an Initial Presentation of Fever of Unknown Origin

ANCA-Associated Vasculitis: Advancement in Pathogenesis, Clinical Features and Management

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