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Monitoring with serum SP-A, SP-D, and KL-6 in a patient with interstitial pneumonia complicated with ANCA-associated glomerulonephritis

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Abstract

A 69-year-old woman was admitted to hospital, complaining of fatigue and dry cough. Her renal function deteriorated rapidly, and the laboratory findings showed elevated myeloperoxidase-specific anti-neutrophil cytoplasmic antibody (ANCA). Renal biopsy examination revealed crescentic glomerulonephritis (pauci-immune type), and linear opacities and a honeycomb appearance in both lower lobes was evident on the chest computed tomography scan. The patient was diagnosed as having ANCA-associated glomerulonephritis complicated with mild interstitial pneumonia (IP). Treatment with methylprednisolone pulse therapy improved both her renal function and IP, but her lung lesions worsened during the course of tapering the prednisolone doses. After careful observation, her IP improved gradually without specific treatment. Worsening or improvement of her lung lesions was accompanied by changes in the serological markers of IP, namely, surfactant protein-A, surfactant protein-D, and KL-6. We found that monitoring these markers was helpful in diagnosing and managing IP in our patient with ANCA-associated vasculitis.

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Authors and Affiliations

  1. Cardiovascular, Respiratory and Neurology Division, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan

    Fumihiko Takahashi, Eriko Miura, Kiyoko Shibukawa, Junko Chinda, Kenjiro Kikuchi & Naoyuki Hasebe

  2. Department of Surgical Pathology, Asahikawa Medical University, Asahikawa, Japan

    Naoyuki Miyokawa

  3. Imamoto Clinic, Asahikawa, Japan

    Chieko Imamoto

  4. Department of Cardiovascular Medicine, Rumoi City Hospital, 2-16, Shinonome-cho, Rumoi, 077-8511, Japan

    Fumihiko Takahashi

Authors
  1. Fumihiko Takahashi
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  2. Eriko Miura
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  3. Kiyoko Shibukawa
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  4. Junko Chinda
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  5. Naoyuki Miyokawa
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  6. Chieko Imamoto
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  7. Kenjiro Kikuchi
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  8. Naoyuki Hasebe
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Correspondence to Fumihiko Takahashi.

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Takahashi, F., Miura, E., Shibukawa, K. et al. Monitoring with serum SP-A, SP-D, and KL-6 in a patient with interstitial pneumonia complicated with ANCA-associated glomerulonephritis. CEN Case Rep 3, 5–9 (2014). https://doi.org/10.1007/s13730-013-0074-1

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  • DOI: https://doi.org/10.1007/s13730-013-0074-1

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