Muscle Biopsy-proven Drug-induced Microscopic Polyangiitis in a Patient with Tuberculosis

Intern Med. 2023 Jan 1;62(1):129-133. doi: 10.2169/internalmedicine.9599-22. Epub 2022 May 31.

Abstract

We herein report a case of muscle biopsy-proven microscopic polyangiitis (MPA) in a patient with tuberculosis. The patient had developed a persistent fever after the initiation of treatment for tuberculosis and was positive for myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA). However, because conventional symptoms were lacking, determination of the biopsy site was difficult. Based on the findings of a biopsy of the biceps femoris, which confirmed small vessel vasculitis, the patient was diagnosed with MPA. The fever was alleviated by glucocorticoids. Tuberculosis and antituberculosis drugs can cause ANCA-associated vasculitis (AAV). A muscle biopsy is useful for the diagnosis of AAV.

Keywords: antineutrophil cytoplasmic antibody; antineutrophil cytoplasmic antibody-associated vasculitis; microscopic polyangiitis; muscle biopsy; tuberculosis.

Publication types

  • Case Reports

MeSH terms

  • Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis*
  • Antibodies, Antineutrophil Cytoplasmic
  • Biopsy
  • Granulomatosis with Polyangiitis*
  • Humans
  • Microscopic Polyangiitis* / complications
  • Microscopic Polyangiitis* / diagnosis
  • Microscopic Polyangiitis* / drug therapy
  • Muscles / pathology
  • Tuberculosis*

Substances

  • Antibodies, Antineutrophil Cytoplasmic