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We report a case of a patient with cholesterol embolism who showed positive for both myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA) and proteinase 3 antineutrophil cytoplasmic antibody (PR3-ANCA) and who was treated with prednisolone (PSL) and cyclophosphamide.
A 50 year old man underwent cardiac catheterisation for back pain. The examination disclosed 90% stenosis of the right coronary artery and a saccular aneurysm in the thoracic aorta. The patient underwent percutaneous transluminal coronary angioplasty and the aneurysm was wrapped with an artificial blood vessel. Postoperatively, the patient had a fever, pleural effusion, abdominal pain, and increased white blood cell (WBC) count, C reactive protein (CRP), and serum creatinine. Cultures of blood and pleural effusion exudate were negative. PSL 15 mg/day was started. However, acute progression of renal failure required …