Microscopic polyangiitis

ANCA-positive microscopic polyangiitis has been associated with propylthiouracil, with a fatal outcome despite treatment with glucocorticoids and cyclophosphamide (87). Another patient presented atypically with acute pericarditis 10 months after starting to take propylthiouracil 100 mg tds (88). Another patient developed ANCA-negative leukocytoclastic vasculitis of the skin (89). 

Seligman VA, Bolton PB, Sanchez HC, Fye KH. Propylthiouracil-induced microscopic polyangiitis. J Clin Rheumatol 2001 7 170-4. 

Kelsall JT, Chalmers A, Sherlock CH, Tron VA, Kelsall AC. Microscopic polyangiitis after influenza vaccination. J Rheumatol 1997 24(6) 1198-202. 

ANCA (by ELISA for MPO-ANCA and PR3-ANCA or by IIF on normal neutrophils). ANCA are markers for the small-vessel vasculitides, such as Wegener granulomatosis, microscopic polyangiitis, and Churg-Strauss syndrome. 

Microscopic polyangiitis (MPA). ANCA-associated necrotizing, pauci immune vasculitis of the small vessels (capillaries, venules, arterioles) frequently associated with rapidly progressive glomerulonephritis and/or haemorrhagic alveolitis as well as autoantibodies against myeloperoxidase. 

By summarizing various studies and case reports, Gregorini (working in Brescia) showed that extrapul-monary silicotic lesions and/or autoimmune processes may play a role in kidney diseases after silica exposure, more specifically MPO-ANCA-positive microscopic polyangiitis and its renal-limited form of idiopathic , rapidly progressive glomerulonephritis (Conrad et al. 

Table 1 Definitions of Wegener s Granulomatosis, Microscopic Polyangiitis, and Churg-Strauss Syndrome Adopted by the Chapel HiU Consensus Conference on the Nomenclature of Systemic Vasculitis...

Table 2 Comparison of Approximate Frequency of Manifestations of Microscopic Polyangiitis to Several Other Forms of Small-Vessel Vascuhtis...

Table 3 Approximate Frequency of ANCA with Specificity for PR3-ANCA or MPO-ANCA in Patients with Active Untreated Wegener s Granulomatosis (Systemic, Not Limited), Microscopic Polyangiitis, Churg-Strauss Syndrome, and Renal-limited Pauci-immune Crescentic Glomerulonephritis...

Wegener s granulomatosis Microscopic polyangiitis Churg-Strauss syndrome Renal-limited vasculitis... 

Mohammad AJ, Jacobsson LT, Mahr AD, et al. Prevalence of Wegener s granulomatosis, microscopic polyangiitis, polyarteritis nodosa and Churg-Strauss syndrome within a defined population in southern Sweden. Rheumatology (Oxford) 2007 46(8) 1329-1337. 

Mahr A, Guillevin L, Poissonnet M, et al. Prevalences of polyarteritis nodosa, microscopic polyangiitis, Wegener s granulomatosis, and Churg-Strauss syndrome in a French urban multiethnic population in 2000 a capture-recapture estimate. Arthritis Rheum 2004 51(l) 92-99. 

Cattaneo L, Chierici E, Pavone L, et al. Peripheral neuropathy in Wegener s granulomatosis, Churg-Strauss syndrome and microscopic polyangiitis. J Neurol Neurosurg Psychiatry 2007 78(10) 1119-1123. 

Nowack R Gobel U, Klooker P, et al. Mycophenolate mofetil for maintenance therapy of Wegener s granulomatosis and microscopic polyangiitis a pilot study in 11 patients with renal involvement. J Am Soc Nephrol 1999 10(9) 1965-1971. 

Guilpain P, Servettaz A, Goulvestre C, et al. Pathogenic effects of antimyeloperoxidase antibodies in microscopic polyangiitis. Arthritis Rheum 2007 56(7) 2455 463. 

Bansal PJ, Tobin MC. Neonatal microscopic polyangiitis secondary to transfer of maternal myeloperoxidase-antineutrophil c)doplasmic antibody resulting in neonatal pulmonary hemorrhage and renal involvement. Ann Allergy Asthma Immunol 2004 93 398 01. 

Guillevin L, Durand-GasseUn B, Cevallos R, et al. Microscopic polyangiitis clinical and laboratory findings in eighty-five patients. Arthritis Rheum 1999 42 421 30. 

Becker-Merok A, Nossent JC, Ritland N. Fibrosing alveolitis predating microscopic polyangiitis. Scand J Rheumatol 1999 28 254-256. 

El-Mistiy N, Pusey CD, Gaskin G. Markers of pulmonary haemorrhage in microscopic polyangiitis. Sarcoidosis Vase Diffuse Lung Dis 1996 13 268. 

Mansi lA, Opran A, Sondhi D, et al. Microscopic polyangiitis presenting as idiopathic pulmonary fibrosis is anti-neutrophilic cytoplasmic antibody testing indicated Am J Med Sci 2001 321 201-202. 

Bimbaum J, Danoff S, Askin FB, et al. Microscopic polyangiitis presenting as a pulmonary-muscle syndrome is subclinical alveolar hemorrhage the mechanism of pulmonary fibrosis Arthritis Rheum 2007 56 2065-2071. 

Betensley AD, Yankaskas JR. Factor viia for alveolar hemorrhage in microscopic polyangiitis. Am J Respir Grit Care Med 2002 166 1291-1292. 

Lauque D, Cadranel J, Lazor R, et al. Microscopic polyangiitis with alveolar hemorrhage. A study of 29 cases and review of the literature. Groupe d Etudes et de Recherche sur les Maladies OrpheUnes Pulmonaires (GERM 0 P). Medicine (Baltimore) 2000 79 222-233. 

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