Onset of microscopic polyangiitis in binephrectomied patient on chronic hemodialysis-Case report

Abstract

Introduction: Microscopic polyangiitis (MPA) is one of the causes of the pulmonary-renal syndrome associated with elevated non-specific markers of inflammation and antineutrophil cytoplasmic autoantibody (ANCA) positivity in 50-75%. De novo occurrence of the disease in patients on chronic hemodialysis (HD) has not been described. Case presentation: We presented patient who developed MPO-ANCA-associated MPA with lung and musculoskeletal involvement after 4 years on regular HD due to bilateral nephrectomy. After excluding the other causes of MPO-ANCA positivity, diagnosis was confirmed even without renal biopsy. Patient received standard immunosuppression therapy and he is still in remission after 27 months. Conclusion: The onset of immune-mediated disease could be observed even after introduction of renal replacement therapy, which may be a diagnostic problem. Early recognition and traditional immunosuppressive regiment may provide successful outcome. © 2017 Jankovic, Maslarevic-Radovic, Djuric, Tosic-Dragovic, Bulatovic, Simovic, Mitrovic, Stankovic-Popovic, Dopudja-Pantic, Arandjelovic and Dimkovic.