To the issue of differential diagnosis of ANCA-positive generalized sarcoidosis and ANCA-associated polyangiitis
https://doi.org/10.18093/0869-0189-2017-28-3-496-502
Abstract
An autopsy case of a female patient of 65 years old was reported in the article. This case demonstrated clinical and anatomical features of chronic generalized sarcoidosis with predominant lesion of the lungs (extended bilateral fibrosis) and the kidneys (interstitial nephritis with segmental glomerulosclerosis). Long-term steroid therapy resulted in a significant slowing progression of the disease. This case was characterized by a prominent vasculitis which caused the misdiagnosis of ANCA- associated polyangiitis. Severe anemia and secondary immunodeficiency that were partially druginduced due to the long-term steroid therapy were other manifestations of this disease. The advanced disease was complicated by lower respiratory tract infection, acute respiratory distress-syndrome, and multiple organ dysfunction that caused the patient’s death. A comprehensive pathological investigation including immunohistochemistry had the crucial role for the final diagnosis.
About the Authors
G. B. Koval’skiy
Saint-Petersburg City State Pathological Bureau
Russian Federation
Russian Federation
Doctor of Medicine, Professor, Head
tel.: (812) 338-48-60
Uchebnyy per. 5, Saint Petersburg, 194354, Russia
B. M. Ariel'
Saint-Petersburg City State Pathological Bureau
Russian Federation
Russian Federation
Doctor of Medicine, Professor, Member of Council Board
tel.: (812) 513-60-98
Uchebnyy per. 5, Saint Petersburg, 194354, Russia
V. A. Volchkov
Saint-Petersburg City State Multidisciplinar Hospital No.2
Russian Federation
Russian Federation
Doctor of Medicine, Professor, Hospital Chief
tel.: (812) 338-64-54
Uchebnyy per. 5, Saint Petersburg, 194354, Russia
I. A. Danilova
Saint-Petersburg City State Pathological Bureau
Russian Federation
Russian Federation
Doctor of Medicine, Professor, Head
tel.: (812) 338-94-10
Uchebnyy per. 5, Saint Petersburg, 194354, Russia
A. G. Poliyevets
Saint-Petersburg City State Pathological Bureau
Russian Federation
Russian Federation
a pathologist
tel.: (812) 338-94-95
Uchebnyy per. 5, Saint Petersburg, 194354, Russia
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Review
For citations:
Koval’skiy G.B., Ariel' B.M., Volchkov V.A., Danilova I.A., Poliyevets A.G. To the issue of differential diagnosis of ANCA-positive generalized sarcoidosis and ANCA-associated polyangiitis. PULMONOLOGIYA. 2018;28(4):496-502. (In Russ.) https://doi.org/10.18093/0869-0189-2017-28-3-496-502
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