Kidney Res Clin Pract.  2018 Jun;37(2):174-177. 10.23876/j.krcp.2018.37.2.174.

A case of microscopic polyangiitis presenting with acute spinal subdural hemorrhage

• Suh WY
• Lee EK

• KMID: 2416086
• DOI: http://doi.org/10.23876/j.krcp.2018.37.2.174

Abstract

This report describes a case of a 62-year-old woman with microscopic polyangiitis (MPA) who developed acute spinal subdural hemorrhage. MPA was confirmed by positive autoantibodies to myeloperoxidase and focal segmental necrotizing and pauci-immune crescentic glomerulonephritis on renal biopsy. She did not recover from paraplegia due to acute spinal subdural hemorrhage, despite decompression operation and aggressive immunosuppression. Although spontaneous spinal hemorrhage in MPA patients is very rare, the prognosis for such patients is poor. Considering the possibility of ongoing vasculitis activity in extra-renal organs, clinicians should be very cautious to attenuate the strength of immunosuppressant drugs, even in patients with chronic or irreversible renal pathology.

Keyword

Microscopic polyangiitis; Spinal; Spinal subdural hematoma

MeSH Terms

Autoantibodies
Biopsy
Decompression
Female
Glomerulonephritis
Hematoma, Subdural*
Hematoma, Subdural, Spinal
Hemorrhage
Humans
Immunosuppression
Microscopic Polyangiitis*
Middle Aged
Paraplegia
Pathology
Peroxidase
Prognosis
Vasculitis
Autoantibodies
Peroxidase