Ulcerative Colitis with Positivity for Proteinase 3-Antineutrophil Cytoplasmic Antibody

摘要

A 33-year-old woman was admitted to our hospital with cough and fever (over 39.0degC). About 1 month prior to the current admission, she had presented with fever (over 39.0癈), diarrhea and bloody bowel discharge. On admission, her hemoglobin was 8.9 g/dl and the serum C-reac-tive protein level was 6.8 mg/dl. Colonoscopy revealed flare and erosions in the entire large intestine and the patient was diagnosed as having ulcerative colitis (fig. 1). Myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) was negative, whereas the proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA) titer was increased to 135 EU. As the patient was PR3-ANCA-positive, we focused our examination on the lungs, kidneys and nasopharynx, which are the most frequent sites of involvement in We-gner's granulomatosis. However, these examinations revealed no specific findings. With mesalazine therapy and bowel rest for 10 days, the patient became afebrile, her cough'remitted and the gastrointestinal symptoms, namely, diarrhea and bloody bowel discharge, resolved.