A Case of Microscopic Polyangiitis with Ischemic Colitis / 대한신장학회잡지

ABSTRACT

Microscopic polyangiitis (MPA) is a systemic small vessel vasculitis, which is frequently complicated with rapidly progressive necrotizing glomerulonephritis. Patients with MPA often have demonstrable perinuclear antineutrophil cytoplasm antibodies (p-ANCA) in serum. The most common age of onset is 40 to 60 years and is more common in men. Gastrointestinal (GI) tract involvement is present in about 30-40%. Small bowel involvement is more common and ischemic colitis in the rectum is rare. We have experienced a case of microscopic polyangiitis with ischemic colitis in the rectum, p-ANCA positive and cresent formation on renal biopsy. A 72-year-old woman was admitted with two weeks history of abdominal pain. Total colonoscopy revealed colon obstruction with severe mucosal edema. Urine study showed hematuria and proteinuria. Serum creatinine was elevated progressively. Serume p-ANCA was positive. The titer of p-ANCA was decreased and colon obstruction was recovered after steroid and cyclophosphamide therapy.