caa a22 4500 445883065 CHVBK 20180317145550.0 cr unu---uuuuu 170323e20110601xx s 000 0 eng 10.1007/s10157-011-0406-4 doi (NATIONALLICENCE)springer-10.1007/s10157-011-0406-4 A case of femoral hemorrhage in a patient with microscopic polyangiitis with low levels of myeloperoxidase-antineutrophil cytoplasmic autoantibody [Elektronische Daten] [Masanori Abe, Kazuyoshi Okada, Noriaki Maruyama, Shiro Matsumoto, Yoshinobu Fuke, Takayuki Fujita, Masayoshi Soma, Koichi Matsumoto] We present the case of a 67-year-old female with femoral hemorrhage accompanied by microscopic polyangiitis. She was admitted to our hospital with symptoms of general fatigue, fever, and edema of the lower limbs. She was diagnosed with microscopic polyangiitis on the basis of the cardinal symptoms of the condition, including rapidly progressive glomerulonephritis and the presence of myeloperoxidase-antineutrophil cytoplasmic autoantibody (MPO-ANCA), albeit at a low titer. Renal biopsy demonstrated the presence of fibrocellular crescent-shaped glomeruli with interstitial infiltration. No immune deposits were detected in immunofluorescence studies. The patient was treated with steroids and anti-platelet agents; subsequently, the inflammatory reaction subsided and MPO-ANCA and C-reactive protein titers decreased. However, on day 14, the patient experienced sudden onset of swelling in the left femoral region accompanied by hypotension. Her hemoglobin level dropped from 8.8 to 4.5g/dl in the subsequent hours. Although computed tomography of the legs revealed an extensive hematoma in the left quadriceps femoris muscle, the patient recovered after receiving a transfusion and supportive therapy with discontinuation of dipyridamole. Thereafter, her renal function improved, and she was discharged. To our knowledge, this is the first report of a case of microscopic polyangiitis accompanied by femoral hemorrhage. Japanese Society of Nephrology, 2011 ANCA-associated vasculitis nationallicence Femoral hemorrhage nationallicence MPO-ANCA nationallicence Microscopic polyangiitis nationallicence Rapidly progressive glomerulonephritis nationallicence Abe Masanori Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut Okada Kazuyoshi Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut Maruyama Noriaki Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut Matsumoto Shiro Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut Fuke Yoshinobu Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut Fujita Takayuki Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut Soma Masayoshi Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan aut Matsumoto Koichi Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut Clinical and Experimental Nephrology Springer Japan 15/3(2011-06-01), 414-418 1342-1751 15:3<414 2011 15 10157 https://doi.org/10.1007/s10157-011-0406-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-011-0406-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Abe Masanori Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut NATIONALLICENCE 700 1- Okada Kazuyoshi Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut NATIONALLICENCE 700 1- Maruyama Noriaki Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut NATIONALLICENCE 700 1- Matsumoto Shiro Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut NATIONALLICENCE 700 1- Fuke Yoshinobu Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut NATIONALLICENCE 700 1- Fujita Takayuki Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut NATIONALLICENCE 700 1- Soma Masayoshi Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan aut NATIONALLICENCE 700 1- Matsumoto Koichi Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine, Nihon University School of Medicine, 30-1 Oyaguchi Kami-chou, Itabashi-ku, 173-8610, Tokyo, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/3(2011-06-01), 414-418 1342-1751 15:3<414 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer