Abstract
A 74-year-old woman developed fever, numbness of legs and glomerulonephritis. Antineutrophil cytoplasmic autoantibodies specific for myeloperoxidase (MPO-ANCA) were positive in her serum, and she presented with acute renal failure. She was also simultaneously diagnosed as having both gastric and duodenal cancers. Complete resection of both cancers and renal biopsy was performed. Some glomeruli showed cellular crescentic changes, while submucosal necrotizing vasculitis of small vessels was noted adjacent to the gastric cancer. A diagnosis of microscopic polyangitis was made. After the operation, the patient's fever, renal failure and microscopic hematuria improved and obvious reductions in her serum soluble receptors of interleukin 2 values and MPO-ANCA titer were observed without any further treatment. However, the patient's proteinuria, cylinduria, and elevated C-reactive protein persisted; these findings eventually resolved after treatment with 30 mg of prednisolone daily. An immunohistochemical analysis showed that CD8 T lymphocytes had infiltrated both the carcinomas and the renal lesions. Our case suggests that CD8 T cells induced as part of an immune response against carcinoma may play a pathologic role in ANCA-positive paraneoplastic syndrome.
| Original language | English |
|---|---|
| Pages (from-to) | 105-108 |
| Number of pages | 4 |
| Journal | Rheumatology International |
| Volume | 31 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2011 Jan |
| Externally published | Yes |
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Keywords
- Antineutrophil cytoplasmic autoantibodies
- CD8
- Microscopic polyangitis
- Paraneoplastic syndrome
- T cell
ASJC Scopus subject areas
- Rheumatology
- Immunology
- Immunology and Allergy
Cite this
Microscopic polyangitis complicating double carcinoma of the stomach and duodenum : Improvement after the resection of these carcinomas. / Abe, Haruo; Momose, Shuji; Takeuchi, Tsutomu.
In: Rheumatology International, Vol. 31, No. 1, 01.2011, p. 105-108.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Microscopic polyangitis complicating double carcinoma of the stomach and duodenum
T2 - Improvement after the resection of these carcinomas
AU - Abe, Haruo
AU - Momose, Shuji
AU - Takeuchi, Tsutomu
PY - 2011/1
Y1 - 2011/1
N2 - A 74-year-old woman developed fever, numbness of legs and glomerulonephritis. Antineutrophil cytoplasmic autoantibodies specific for myeloperoxidase (MPO-ANCA) were positive in her serum, and she presented with acute renal failure. She was also simultaneously diagnosed as having both gastric and duodenal cancers. Complete resection of both cancers and renal biopsy was performed. Some glomeruli showed cellular crescentic changes, while submucosal necrotizing vasculitis of small vessels was noted adjacent to the gastric cancer. A diagnosis of microscopic polyangitis was made. After the operation, the patient's fever, renal failure and microscopic hematuria improved and obvious reductions in her serum soluble receptors of interleukin 2 values and MPO-ANCA titer were observed without any further treatment. However, the patient's proteinuria, cylinduria, and elevated C-reactive protein persisted; these findings eventually resolved after treatment with 30 mg of prednisolone daily. An immunohistochemical analysis showed that CD8 T lymphocytes had infiltrated both the carcinomas and the renal lesions. Our case suggests that CD8 T cells induced as part of an immune response against carcinoma may play a pathologic role in ANCA-positive paraneoplastic syndrome.
AB - A 74-year-old woman developed fever, numbness of legs and glomerulonephritis. Antineutrophil cytoplasmic autoantibodies specific for myeloperoxidase (MPO-ANCA) were positive in her serum, and she presented with acute renal failure. She was also simultaneously diagnosed as having both gastric and duodenal cancers. Complete resection of both cancers and renal biopsy was performed. Some glomeruli showed cellular crescentic changes, while submucosal necrotizing vasculitis of small vessels was noted adjacent to the gastric cancer. A diagnosis of microscopic polyangitis was made. After the operation, the patient's fever, renal failure and microscopic hematuria improved and obvious reductions in her serum soluble receptors of interleukin 2 values and MPO-ANCA titer were observed without any further treatment. However, the patient's proteinuria, cylinduria, and elevated C-reactive protein persisted; these findings eventually resolved after treatment with 30 mg of prednisolone daily. An immunohistochemical analysis showed that CD8 T lymphocytes had infiltrated both the carcinomas and the renal lesions. Our case suggests that CD8 T cells induced as part of an immune response against carcinoma may play a pathologic role in ANCA-positive paraneoplastic syndrome.
KW - Antineutrophil cytoplasmic autoantibodies
KW - CD8
KW - Microscopic polyangitis
KW - Paraneoplastic syndrome
KW - T cell
UR - http://www.scopus.com/inward/record.url?scp=78751588547&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78751588547&partnerID=8YFLogxK
U2 - 10.1007/s00296-009-1162-6
DO - 10.1007/s00296-009-1162-6
M3 - Article
C2 - 19847435
AN - SCOPUS:78751588547
VL - 31
SP - 105
EP - 108
JO - Rheumatology International
JF - Rheumatology International
SN - 0172-8172
IS - 1
ER -