Alpha-1 Antitrypsin Deficiency Presenting with MPO-ANCA Associated Vasculitis and Aortic Dissection

The combination of alpha-1 antitrypsin (AAT) deficiency, ANCA-vasculitis, and aortic aneurysm has been rarely described in literature. We report an eventually fatal case in a 70-year-old patient who initially presented with giant cell arteritis and ANCA associated glomerulonephritis. Several years l...

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Main Authors: Bram M. Voorzaat, Jan van Schaik, Stijn L. P. Crobach, Catharina S. P. van Rijswijk, Joris I. Rotmans
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2017/8140641
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author Bram M. Voorzaat
Jan van Schaik
Stijn L. P. Crobach
Catharina S. P. van Rijswijk
Joris I. Rotmans
author_facet Bram M. Voorzaat
Jan van Schaik
Stijn L. P. Crobach
Catharina S. P. van Rijswijk
Joris I. Rotmans
author_sort Bram M. Voorzaat
collection DOAJ
description The combination of alpha-1 antitrypsin (AAT) deficiency, ANCA-vasculitis, and aortic aneurysm has been rarely described in literature. We report an eventually fatal case in a 70-year-old patient who initially presented with giant cell arteritis and ANCA associated glomerulonephritis. Several years later, he presented with aortic dissection due to large vessel vasculitis, raising the suspicion of AAT deficiency, as two first-line relatives had chronic obstructive pulmonary disease, while they never smoked. This diagnosis was confirmed by AAT electrophoresis and immunohistochemistry on a temporal artery biopsy. Considering AAT deficiency in these cases might lead to a more timely diagnosis.
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institution Kabale University
issn 1687-9627
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publishDate 2017-01-01
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spelling doaj-art-db249b7375e6472ea5bd3a7ace6375d02025-02-03T05:52:19ZengWileyCase Reports in Medicine1687-96271687-96352017-01-01201710.1155/2017/81406418140641Alpha-1 Antitrypsin Deficiency Presenting with MPO-ANCA Associated Vasculitis and Aortic DissectionBram M. Voorzaat0Jan van Schaik1Stijn L. P. Crobach2Catharina S. P. van Rijswijk3Joris I. Rotmans4Department of Nephrology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Surgery, Leiden University Medical Center, Leiden, NetherlandsDepartment of Pathology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Radiology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Nephrology, Leiden University Medical Center, Leiden, NetherlandsThe combination of alpha-1 antitrypsin (AAT) deficiency, ANCA-vasculitis, and aortic aneurysm has been rarely described in literature. We report an eventually fatal case in a 70-year-old patient who initially presented with giant cell arteritis and ANCA associated glomerulonephritis. Several years later, he presented with aortic dissection due to large vessel vasculitis, raising the suspicion of AAT deficiency, as two first-line relatives had chronic obstructive pulmonary disease, while they never smoked. This diagnosis was confirmed by AAT electrophoresis and immunohistochemistry on a temporal artery biopsy. Considering AAT deficiency in these cases might lead to a more timely diagnosis.http://dx.doi.org/10.1155/2017/8140641
spellingShingle Bram M. Voorzaat
Jan van Schaik
Stijn L. P. Crobach
Catharina S. P. van Rijswijk
Joris I. Rotmans
Alpha-1 Antitrypsin Deficiency Presenting with MPO-ANCA Associated Vasculitis and Aortic Dissection
Case Reports in Medicine
title Alpha-1 Antitrypsin Deficiency Presenting with MPO-ANCA Associated Vasculitis and Aortic Dissection
title_full Alpha-1 Antitrypsin Deficiency Presenting with MPO-ANCA Associated Vasculitis and Aortic Dissection
title_fullStr Alpha-1 Antitrypsin Deficiency Presenting with MPO-ANCA Associated Vasculitis and Aortic Dissection
title_full_unstemmed Alpha-1 Antitrypsin Deficiency Presenting with MPO-ANCA Associated Vasculitis and Aortic Dissection
title_short Alpha-1 Antitrypsin Deficiency Presenting with MPO-ANCA Associated Vasculitis and Aortic Dissection
title_sort alpha 1 antitrypsin deficiency presenting with mpo anca associated vasculitis and aortic dissection
url http://dx.doi.org/10.1155/2017/8140641
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