Progressive obstructive lung disease associated with microscopic polyangiitis

Am J Respir Crit Care Med. 1997 Feb;155(2):739-42. doi: 10.1164/ajrccm.155.2.9032221.


Small airway involvement and progressive severe airflow obstruction are unexpected features in patients with microscopic polyangiitis. We report the case of a patient with microscopic polyangiitis and circulating anti-neutrophil cytoplasmic antibodies (ANCA), who developed pulmonary hyperinflation and airflow obstruction over a 7-yr period. Systemic manifestations of this vasculitis improved under corticosteriods and cyclophosphamid therapy, a treatment that did not influence either the very high level of anti-myeloperoxidase antibodies or the ventilatory impairment. Small airway involvement was suspected on the basis of pathologic small airway lesions and a mild emphysematous pattern on computed tomography (CT) scan, which was out of proportion with the severity of the obstructive lung disease.

Publication types

  • Case Reports

MeSH terms

  • Airway Obstruction / etiology
  • Antibodies, Antineutrophil Cytoplasmic / blood*
  • Bronchoalveolar Lavage Fluid
  • Cyclophosphamide / therapeutic use
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lung Diseases, Obstructive / physiopathology*
  • Middle Aged
  • Prednisone / therapeutic use
  • Respiratory Function Tests
  • Vasculitis / drug therapy
  • Vasculitis / physiopathology*


  • Antibodies, Antineutrophil Cytoplasmic
  • Glucocorticoids
  • Immunosuppressive Agents
  • Cyclophosphamide
  • Prednisone