American Journal of Respiratory and Critical Care Medicine · 1997 · 33 citations · 0 references
MedicineInternal MedicinePathologyAutoimmunityImmunopathologyPulmonologyAirway ObstructionObstructive Lung DiseasePulmonary InflammationPulmonary PathologyRespiratory DiseaseRespiratory PathologyAirflow Obstruction AssessmentAnti-myeloperoxidase AntibodiesAnti-neutrophil Cytoplasmic AntibodiesAntineutrophil Cytoplasmic AntibodiesLung DiseasesLung HyperinflationPulmonary Involvement In VasculitisSmall Airway Disease Imaging
Small airway involvement and progressive severe airflow obstruction are unexpected features in patients with microscopic polyangiitis. We report the case of a patient with microscopic polyangiitis and circulating anti-neutrophil cytoplasmic antibodies (ANCA), who developed pulmonary hyperinflation and airflow obstruction over a 7-yr period. Systemic manifestations of this vasculitis improved under corticosteriods and cyclophosphamid therapy, a treatment that did not influence either the very high level of anti-myeloperoxidase antibodies or the ventilatory impairment. Small airway involvement was suspected on the basis of pathologic small airway lesions and a mild emphysematous pattern on computed tomography (CT) scan, which was out of proportion with the severity of the obstructive lung disease.