Granulomatosis with Polyangiitis Restricted to the Back Muscle: The First Case Report

Medicina (Kaunas). 2020 Aug 27;56(9):431. doi: 10.3390/medicina56090431.

Abstract

Granulomatosis with polyangiitis (GPA) is an autoimmune disease which is a type of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis that frequently affects the lungs and kidneys. However, GPA limited to a single organ has also been reported. A 71-year-old man was admitted for back pain and fever. We detected elevated levels of inflammatory markers and myeloperoxidase-ANCA. Magnetic resonance imaging indicated diffuse inflammation of the back and psoas muscles. Histology showed degenerated muscle fibers and granulomatosis vasculitis with mixed lymphoplasma cell infiltration. High-dose methylprednisolone therapy improved his symptoms. A final diagnosis of GPA limited to the muscles was made.

Keywords: ANCA-associated vasculitis; GPA; organ limited vasculitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Antineutrophil Cytoplasmic / blood
  • Back Muscles / diagnostic imaging
  • Back Muscles / pathology*
  • Biomarkers / blood
  • Granulomatosis with Polyangiitis / blood
  • Granulomatosis with Polyangiitis / diagnostic imaging
  • Granulomatosis with Polyangiitis / drug therapy
  • Granulomatosis with Polyangiitis / pathology*
  • Humans
  • Male
  • Methylprednisolone / therapeutic use
  • Peroxidase / blood
  • Psoas Muscles / diagnostic imaging
  • Psoas Muscles / pathology

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Antineutrophil Cytoplasmic
  • Biomarkers
  • Peroxidase
  • Methylprednisolone