Anti-neutrophil cytoplasmic antibodies associated vasculitis with interstitial lung disease: a case report

Vinus Taneja; Pooja Khosla; Rishikesh Dessai

doi:10.18203/2320-6012.ijrms20240240

Authors

Vinus Taneja Department of Medicine, Sir Ganga Ram Hospital, New Delhi, Delhi, India
Pooja Khosla Department of Medicine, Sir Ganga Ram Hospital, New Delhi, Delhi, India
Rishikesh Dessai Department of Medicine, Sir Ganga Ram Hospital, New Delhi, Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20240240

Keywords:

ANCA, Vasculitis, Interstitial lung disease, AAV

Abstract

Anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis is a necrotizing vasculitis that primarily affect small blood vessels of the airway and kidneys. The major clinicopathologic feature include microscopic polyangiitis and granulomatosis with polyangiitis. There are several studies done that have shown the association of interstitial lung disease (ILD) and ANCA vasculitis. Majority of the studies showed that the prognosis was bad in patients with AAV and ILD, then those without it, and patients with pulmonary fibrosis and ANCA had as low a prognosis as patients with IPF without ANCA. We hereby report a case of a female patient in her 70s who was been treated as a case of infection at different hospital, only to be diagnosed later as ANCA associated vasculitis with interstitial lung disease. Methylenetetrahydrofolate reductase (MTHFR) enzyme is one of the key enzymes involved in the metabolism of folate.

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References

Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65:1-11.

Ando M, Miyazaki E, Ishii T, Mukai Y, Yamasue M, Fujisaki H, et al. Incidence of myeloperoxidase anti-neutrophil cytoplasmic antibody positivity and microscopic polyangitis in the course of idiopathic pulmonary fibrosis. Respir Med. 2013;107:608-15.

Arulkumaran N, Periselneris N, Gaskin G, Strickland N, Ind PW, Pusey CD, et al. Interstitial lung disease and ANCA-associated vasculitis: a retrospective observational cohort study. Rheumatology (Oxford). 2011;50(11):2035-43.

Nada AK, Torres VE, Ryu JH, Lie JT, Holley KE. Pulmonary fibrosis as an unusual clinical manifestation of a pulmonary-renal vasculitis in elderly patients. Mayo Clin Proc. 1990;65(6):847-56.

Katsumata Y, Kawaguchi Y, Yamanaka H. Interstitial Lung Disease with ANCA-associated Vasculitis. Clin Med Insights Circ Respir Pulm Med. 2015;9(1):51-6.

Kagiyama N, Takayanagi N, Kanauchi T, Ishiguro T, Yanagisawa T, Sugita Y. Antineutrophil cytoplasmic antibody-positive conversion and microscopic polyangiitis development in patients with idiopathic pulmonary fibrosis. BMJ Open Respir Res. 2015;2(1):e000058.

Foulon G, Delaval P, Valeyre D, Wallaert B, Debray MP, Brauner M, et al. ANCA-associated lung fibrosis: analysis of 17 patients. Respir Med. 2008;102(10):1392-8.

Schnabel A, Reuter M, Csernok E, Richter C, Gross WL. Subclinical alveolar bleeding in pulmonary vasculitides: correlation with indices of disease activity. Eur Respir J. 1999;14(1):118-24.

Foucher P, Heeringa P, Petersen AH, Huitema MG, Brouwer E, Tervaert JW, et al. Antimyeloperoxidase-associated lung disease. An experimental model. Am J Respir Crit Care Med. 1999;160(3):987-94.

Tzelepis GE, Kokosi M, Tzioufas A, Toya SP, Boki KA, Zormpala A, et al. Prevalence and outcome of pulmonary fibrosis in microscopic polyangiitis. Eur Respir J. 2010;36(1):116-21.