Abstract
We report a case of a 76-year-old woman, presenting with a persistent dry cough, subfebrility, arthralgia and myalgia, weight loss and a breast lesion. She has elevated inflammatory parameters, impaired renal function with proteinuria, bilateral lung nodules on computed tomography scan (CT scan) and a suspect lesion on mammography. A diagnosis of microscopic polyangiitis with involvement of the breast is made based on clinical and radiographic findings, with positive auto-immune serology and histological confirmation. Although vasculitis of the breast is uncommon, this case illustrates that when a breast lesion is found, in combination with constitutional symptoms, we should think about the possibility of an anti-Neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis. Therefore it may be important to perform auto-immune serology in these cases before proceeding to major surgery.
MeSH terms
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Aged
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Anti-Inflammatory Agents / administration & dosage
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Anti-Inflammatory Agents / adverse effects
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Antibodies, Antineutrophil Cytoplasmic / blood*
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Azathioprine / administration & dosage
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Azathioprine / adverse effects
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Breast Diseases / diagnosis*
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Breast* / blood supply
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Breast* / pathology
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Cyclophosphamide / administration & dosage
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Cyclophosphamide / adverse effects
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Diagnosis, Differential
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Drug Therapy, Combination
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Female
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Humans
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Immunologic Factors / blood
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Immunosuppressive Agents / administration & dosage
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Immunosuppressive Agents / adverse effects
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Mammography
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Methylprednisolone / administration & dosage
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Methylprednisolone / adverse effects
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Microscopic Polyangiitis* / diagnosis
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Microscopic Polyangiitis* / drug therapy
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Microscopic Polyangiitis* / immunology
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Microscopic Polyangiitis* / physiopathology
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Microvessels / pathology
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Tomography, X-Ray Computed
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Treatment Outcome
Substances
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Anti-Inflammatory Agents
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Antibodies, Antineutrophil Cytoplasmic
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Immunologic Factors
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Immunosuppressive Agents
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Cyclophosphamide
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Azathioprine
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Methylprednisolone