Microscopic Polyangiitis That Presented Liver Dysfunction Prior to Noted Renal Manifestations

Teruko NAKAMOTO; Masahide YOSHIKAWA; Toshiya NAKATANI; Yoshiko YAMANE; Shu IWASAWA; Madoka MATSUMOTO; Masaki KAWANAMI; Kimio NISHIMURA; Shigehiko UEDA; Hiroshi FUKUI

doi:10.2169/internalmedicine.39.517

Teruko NAKAMOTO, Masahide YOSHIKAWA, Toshiya NAKATANI, Yoshiko YAMANE, Shu IWASAWA, Madoka MATSUMOTO, Masaki KAWANAMI, Kimio NISHIMURA, Shigehiko UEDA, Hiroshi FUKUI

Author information

Teruko NAKAMOTO
the Department of Internal Medicine, Takanohara General Hospital
Masahide YOSHIKAWA
the Department of Parasitology, Nara Medical University
Toshiya NAKATANI
the Department of Internal Medicine, Takanohara General Hospital
Yoshiko YAMANE
the Department of Internal Medicine, Takanohara General Hospital
Shu IWASAWA
the Department of Internal Medicine, Takanohara General Hospital
Madoka MATSUMOTO
the Department of Internal Medicine, Takanohara General Hospital
Masaki KAWANAMI
the Department of Internal Medicine, Takanohara General Hospital
Kimio NISHIMURA
the Department of Internal Medicine, Takanohara General Hospital
Shigehiko UEDA
the Third Department of Internal Medicine, Nara Medical University
Hiroshi FUKUI
the Third Department of Internal Medicine, Nara Medical University

Keywords: antineutrophil cytoplasmic autoantibodies (ANCA), small vessel vasculitis, crescentic glomerulonephritis, corticosteroid

JOURNAL FREE ACCESS

2000 Volume 39 Issue 6 Pages 517-521

DOI https://doi.org/10.2169/internalmedicine.39.517

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Abstract

In microscopic polyangiitis (MPA), renal manifestations are very common as first symptoms. Here, we report a case of MPA which presented liver dysfunction prior to noted renal manifestations. A 58-year-old woman was hospitalized because of a fever for 8 weeks. A laboratory examination revealed marked elevation of alkaline phosphatase and γ-glutamyl transpeptidase, while blood urea nitrogen and creatinine levels remained normal. Although apparent renal dysfunction developed in this case soon after hospitalization, physicians should be aware of the variety of clinical manifestations in MPA. Moreover, antineutrophil cytoplasmic autoantibodies were found to be helpful for diagnosing MPA.
(Internal Medicine 39: 517-521, 2000)

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