Thoracic manifestation of myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA)-related disease: CT findings in 149 patients

Objective The purpose of this study was to assess pulmonary CT findings in patients with myeloperooxidase-antineutrophil cytoplasmic antibody (MPO-ANCA)-related disease. Materials and Methods The pulmonary CT scans of 149 patients with elevated serum MPO-ANCA levels (77 with microscopic polyangiitis, 18 with Churg-Strauss syndrome, 12 rapidly progressive glomerulonephritis and 42 with unclassified disease) were retrospectively assessed with regard to parenchymal and mediastinal abnormalities. Results The CT findings consisted of ground-glass attenuation in 110 Patients (74%), consolidation in 67 patients (45%), traction bronchiectasis in 46 patients (31%), and honey combing in 46 patients (31%).Consolidation, thickening of bronchovascular bundle, interlobular septal thickening, and pleural effusion were more frequently observed in patients with classified disease than in those without an unclassified disease. Honeycombing was more frequently observed in patients with unclassified disease than in those with classified disease. Conclusions The CT findings in patients with MPO-ANCA consisted mainly of ground-glass attenuation, consolidation, and traction bronchiectasis. Consolidation, thickening of bronchovascular bundle, interlobular septal thickening, and pleural effusion were more frequently observed in patients with classified disease than in those with unclassified disease. In contrast, honeycombing was more frequently observed in patients with unclassified disease than in those with classified disease.