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2014 ; 3
(1
): 5-9
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Monitoring with serum SP-A, SP-D, and KL-6 in a patient with interstitial
pneumonia complicated with ANCA-associated glomerulonephritis
#MMPMID28509235
Takahashi F
; Miura E
; Shibukawa K
; Chinda J
; Miyokawa N
; Imamoto C
; Kikuchi K
; Hasebe N
CEN Case Rep
2014[May]; 3
(1
): 5-9
PMID28509235
show ga
A 69-year-old woman was admitted to hospital, complaining of fatigue and dry
cough. Her renal function deteriorated rapidly, and the laboratory findings
showed elevated myeloperoxidase-specific anti-neutrophil cytoplasmic antibody
(ANCA). Renal biopsy examination revealed crescentic glomerulonephritis
(pauci-immune type), and linear opacities and a honeycomb appearance in both
lower lobes was evident on the chest computed tomography scan. The patient was
diagnosed as having ANCA-associated glomerulonephritis complicated with mild
interstitial pneumonia (IP). Treatment with methylprednisolone pulse therapy
improved both her renal function and IP, but her lung lesions worsened during the
course of tapering the prednisolone doses. After careful observation, her IP
improved gradually without specific treatment. Worsening or improvement of her
lung lesions was accompanied by changes in the serological markers of IP, namely,
surfactant protein-A, surfactant protein-D, and KL-6. We found that monitoring
these markers was helpful in diagnosing and managing IP in our patient with
ANCA-associated vasculitis.