Interstitial Pneumonia and Nodular Regenerative Hyperplasia of the Liver as Initial Manifestations of Polyarteritis Nodosa
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- Tanaka Ichidai
- Departments of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
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- Imaizumi Kazuyoshi
- Departments of Internal Medicine, Division of Respiratory Medicine and Clinical Allergy, Fujita Health University School of Medicine, Japan
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- Hashimoto Izumi
- Departments of Internal Medicine, Division of Respiratory Medicine and Clinical Allergy, Fujita Health University School of Medicine, Japan
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- Asai Naoya
- Departments of Pathology, Nagoya University Graduate School of Medicine, Japan
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- Yokoi Toyoharu
- Department of Clinical Pathology, Aichi Medical University School of Medicine, Japan
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- Matsuno Tadakatsu
- Division of Respiratory Medicine, Handa City Hospital, Japan
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- Hasegawa Yoshinori
- Departments of Respiratory Medicine, Nagoya University Graduate School of Medicine, Japan
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抄録
A 65-year-old man was admitted to our hospital because of progressive dyspnea. A laboratory examination and high-resolution computed tomography (HRCT) revealed that he had interstitial pneumonia (IP) with liver dysfunction. Myeloperoxidase-ANCA (MPO-ANCA) was negative. Although his respiratory condition had become stable after initiation of steroid therapy, liver dysfunction had worsened with progressive portal hypertension. He died of hepatic insufficiency about three years after the first medical examination.<br> Autopsy showed that he had vasculitis of medium and small blood vessels of the spleen, lungs, and liver. The final diagnosis was classical polyarteritis nodosa (PAN). Microscopically, non-specific interstitial pneumonia was identified in the autopsied lung. The pathological findings of the liver were consistent with nodular regenerative hyperplasia (NRH). We report a case of PAN with IP and NRH preceding findings of systemic vasculitis.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 51 (6), 635-638, 2012
一般社団法人 日本内科学会