We report a case of microscopic polyangiitis (MPA) : a 63 year-old-man presented with ear discharge and hearing loss on both sides. He was treated as a case of acute otitis media and acute mastoiditis, however, his symptoms did not improve. In addition, he complained fever, general fatigue and appitite loss. Chest CT revealed nodular opacities and pleural effusion on the left side. The serum creatinine level and MPO-ANCA titer were elevated. Renal biopy revealed findings suggestive of necrotizing angiitis and glomerulonephritis, therefore, a diagnosis of microscopic polyangiitis was made. Steroid pulse therapy and cyclophosphamide pulse therapy were initiated, with improvement of the patient's symptoms. It is important to make an early diagnosis of MPA as the prognosis of this condition is abysmal.
View full abstract