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Muscle Biopsy-proven Drug-induced Microscopic Polyangiitis in a Patient with Tuberculosis
Authors:Gaku Kuwabara  Koichi Yamada  Kiyomi Tanaka  Satoshi Nozuchi  Waki Imoto  Wataru Shibata  Mitsunori Tohda  Shigenori Kyoh  Yoshiaki Itoh  Motomu Hashimoto  Hiroshi Kakeya
Abstract:
We herein report a case of muscle biopsy-proven microscopic polyangiitis (MPA) in a patient with tuberculosis. The patient had developed a persistent fever after the initiation of treatment for tuberculosis and was positive for myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA). However, because conventional symptoms were lacking, determination of the biopsy site was difficult. Based on the findings of a biopsy of the biceps femoris, which confirmed small vessel vasculitis, the patient was diagnosed with MPA. The fever was alleviated by glucocorticoids. Tuberculosis and antituberculosis drugs can cause ANCA-associated vasculitis (AAV). A muscle biopsy is useful for the diagnosis of AAV.
Keywords:antineutrophil cytoplasmic antibody   antineutrophil cytoplasmic antibody-associated vasculitis   microscopic polyangiitis   muscle biopsy   tuberculosis
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