증례 : Antineutrophil Cytoplasmic Autoantibody 양성인 결절성 다발동맥염 1 예

Anti-neutrophil cytoplasmic autoantibodies are serologic marker for various disease, ranging from multi system vasculitis, such as Wegner's granulomatosis and polyarteritis nodosa, to renal-limited disease (that is, idiopathic crescentic glomerulonephritis) These ANCA-associated diseases share the pathologic feature of necrotizing vascular inflammation with scant immune deposition. In vitro studies suggest that these diseases also have a common immunopathogenesis mediated by ANCA-induced neutrophil activation. We experienced a case of ANCA positive polyarteritis nodosa. The physical exammination of abdomen showed mild direct tenderness on the right upper quadrant. Laboratory studies on admission revealed leukocytosis, elevated ESR, proteinuria, hematuria, and elevated alkaline phosphatase. Liver bipsy and renal biopsy revaled characteristic findings of Polyarteritis Nodosa. Serologic test for ANCA showed central type with 1:1280 of titer. The patients was treated with prednisolone and oral cyclophosphamide but the disease progressed to end-stage renal disease.