Microscopic Polyangiitis Secondary to Mycobacterium Abscessus in a Patient with Bronchiectasis: A Case Report

November 2018 in “ BMC Pulmonary Medicine ”

C. Addy, GR Doran, A. Jones, Gary Wright, S. Caskey, D.G. Downey

microscopic polyangiitis Mycobacterium abscessus bronchiectasis ANCA positive vasculitis P-ANCA MPO-ANCA immunosuppressive therapy antimicrobial therapy vasculitic flares NTM-PD immune function mycobacterial infections immune dysfunction

TLDR A 70-year-old woman with bronchiectasis developed a rare immune disease due to a bacterial infection, requiring a difficult balance of treatments.

The document reported a case of a 70-year-old female with bronchiectasis who developed microscopic polyangiitis (MPA) secondary to Mycobacterium abscessus infection. The patient faced significant complications, including small joint arthralgia, sensorimotor neuropathy, and retinal vein occlusion, and experienced drug intolerances and adverse effects such as alopecia and Achilles tendonitis. Treatment involved a complex regimen of immunosuppressive and antimicrobial therapies, highlighting the difficulty of balancing these treatments. The case emphasized the importance of investigating immune function in patients with mycobacterial infections and was the first to document ANCA-positive vasculitis secondary to M. abscessus, underscoring the intricate relationship between mycobacterial infection and immune dysfunction.