Abstract

LOPEZ-VILLEGAS, Víctor Jaime; MEDINA-MORALES, Diego Alejandro  and  SALDARRIAGA-RWERA, Lina María. Microscopic polyangiitis and antiphospholipid syndrome. An uncommon association. Rev.Colomb.Reumatol. [online]. 2019, vol.26, n.4, pp.285-289.  Epub Nov 01, 2020. ISSN 0121-8123.

Antiphospholipid syndrome is frequently associated with systemic lupus erythematosus and other autoimmune diseases. However, coexistence with primary vasculitis has been poorly reported. The case is presented of a 67-year-old patient with a history of recurrent abortion and chronic pulmonary thromboembolism who was admitted due to haemopty sis. At the initial evaluation, a massive alveolar haemorrhage and glomerulonephritis were diagnosed. The results of the antibodies were positive for ANCA with P-type pattern, anti-myeloperoxidase antibodies, and antiphospholipid antibodies (anti-β2 IgG glycoprotein 1 and lupus anticoagulant). Diagnosis of ANCA positive vasculitis-type microscopic polyangiitis was made in association with antiphospholipid syndrome. Given the clinical context, it was decided to initiate intravenous methylprednisolone in pulses for 3 consecutive days, fol lowed by oral prednisone, and as maintenance therapy, rituximab and anticoagulation with warfarin were instituted. The clinical evolution of the patient was satisfactory, with symp tom control being achieved, as well as a significant improvement of renal and pulmonary function, with a decrease in the Birmingham vasculitis activity score (BVAS).

Keywords : Microscopic polyangiitis; Antiphospholipid syndrome; Vasculitis; Antineutrophil cytoplasmic antibody.

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