Toru Sanai, Takako Hirakawa, Toru Mizumasa and Hideyuki Koga
Seven patients presented a specific renal lesion of rapidly progressive glomerulonephritis with myeloperoxidase anti-neutrophil cytoplasmic antibody. Rapidly progressive glomerulonephritis with myeloperoxidase anti-neutrophil cytoplasmic antibody can be associated with pulmonary hemorrhage and/or pulmonary interstitial fibrosis. The patients included three men and four women with a mean age of 62.4 years. All courses of renal lesions revealed rapidly progressive glomerulonephritis and the serum creatinine levels were 7.1 ± 3.9 mg/dl and the myeloperoxidase anti-neutrophil cytoplasmic antibody was 473 ± 471 EU before treatments. Steroid therapy was administered to all patients, immunosupressive agent to four and hemodialysis in six cases. Four patients experienced a pulmonary hemorrhage and died, but all of three patients with pulmonary interstitial fibrosis survived. All of four cases died due to an infection in pulmonary hemorrhage. Although three patients with pulmonary
interstitial fibrosis were survived, pulmonary hemorrhage indicated a poor prognosis. Pulmonary infection may be fetal in pulmonary hemorrhage, but pulmonary infection was a few in pulmonary interstitial fibrosis.