AUTHOR=Jankovic Aleksandar , Maslarevic-Radovic Vesna , Djuric Petar , Tosic-Dragovic Jelena , Bulatovic Ana , Simovic Nikola , Mitrovic Milos , Stankovic-Popovic Verica , Dopudja-Pantic Vesna , Arandjelovic Snezana , Dimkovic Nada 

TITLE=Onset of Microscopic Polyangiitis in Binephrectomied Patient on Chronic Hemodialysis—Case Report

JOURNAL=Frontiers in Immunology

VOLUME=Volume 8 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2017.00111

DOI=10.3389/fimmu.2017.00111

ISSN=1664-3224

ABSTRACT=Introduction: Microscopic polyangitis (MPA) is one of the causes of the pulmonary-renal syndrome associated with elevated nonspecific markers of inflammation and ANCA-positivity in 50-75%. De novo occurrence of the disease in patients on chronic hemodialysis has not been described.
Case presentation: We presented patient who developed MPO-ANCA-associated MPA with lung and musculoskeletal involvement after four years on regular hemodialysis (HD) due to bilateral nephrectomy. After excluding the other causes of MPO-ANCA positivity, diagnosis was confirmed even without renal biopsy. Patient received standard immunosuppression therapy and he is still in remission after 27 months.   
Conclusion: The onset of immune-mediated disease could be observed even after introduction of renal replacement therapy (RRT) which may be a diagnostic problem. Early recognition and traditional immunosuppressive regiment may provide successful  outcome.