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1 Circulation Journal Vol. 72, Suppl. IV,
2 Churg-Strauss ANCA ANCA Circulation Journal Vol. 72, Suppl. IV, 2008
3 ANCA 1 ANCA ANCA 2 Circulation Journal Vol. 72, Suppl. IV,
4 2 2 2 IgA ANCA MPO-ANCA PR-ANCA MPO- ANCA IC PR3- ANCA PAN MPA AGA WG IgA IC HSP ADL/QOL steroid sparing DNA DNA RF MRA 1322 Circulation Journal Vol. 72, Suppl. IV, 2008
5 g // -D Cox- A IFN- PSL.mg/kg/PSL.mg/kg/ PSL.mg/kg/ PSL.mg/kg/ /L PSL.mg/kg/ /L STTMP/SMX g g/g/g/g/g/ A=mg mg/mg/ /L/L YAM T SD T D RR=. Circulation Journal Vol. 72, Suppl. IV,
6 3 1 a b ACR 2 A B C 1324 Circulation Journal Vol. 72, Suppl. IV, 2008
7 Takayasu s arteritis pulseless disease aortitis syndrome T Numano 3 perivascular cuffing Langhans a ba+ / b+ / C+ P+ p. Circulation Journal Vol. 72, Suppl. IV,
8 CRP PTAPTT AT IgGIgACC HLABHLAB HLAB Digital Subtraction AngiographyDSA 1326 Circulation Journal Vol. 72, Suppl. IV, 2008
9 DCT FDG-PET 57 PET 2030mg/ 60mg/ MTX 615mg/ CPA 50100mg/ mg/m 2 CsA 3mg/kg/ AZP 2mg/kg/ MMF1.53g/ 3mg/kg 25mg 2 Circulation Journal Vol. 72, Suppl. IV,
10 CRP 2 3 IgGIgAC 3 C H L A HLA-B52B CT 2 CTMRA 3 DSACTMRA 4 DSACTMRA 5 DSACTMRA 6 7 DSA 6 1 DSACTMRA Circulation Journal Vol. 72, Suppl. IV, 2008
11 8 mg/ mg/ mg/ A HLA-B CPA MTXAZP CsA MMF TNF- /CRP. mg/dl CT / Bentall CT Bentall elephant trunk staged operation Y Circulation Journal Vol. 72, Suppl. IV,
12 stent high risk stent SPECTPET hyperperfusion syndrome infrarenal MRA CT, HLA-A-B -A-B-DR HLA-B HLA-DPB* HLA-DRB* 1330 Circulation Journal Vol. 72, Suppl. IV, 2008
13 1331 Circulation Journal Vol. 72, Suppl. IV, 2008 rubor
14 A B MRA 3D-CT PGE - CDlipoPGE 1332 Circulation Journal Vol. 72, Suppl. IV, 2008
15 .km/h EPC Fontaine13 Fontaine Fontaine Fontaine.. Fontaine visceral artery... Circulation Journal Vol. 72, Suppl. IV,
16 temporal arteritis giant cell arteritis... jaw claudication CRP PMR 14 cm : MRImagnetic resonance imagingfdg-pet /Westergren 5 5 3* * 1334 Circulation Journal Vol. 72, Suppl. IV, 2008
17 fluorodeoxyglucose-positron emission tomography PET PSLmg/kg mg/psl.mg/. PSL mg/ PSL mg/b PSL mg/kg/b CRP mg/ mg mg/.mg mg mg/ PSL mg/ B MTX MTX ADL QOL TNF-... PMR Circulation Journal Vol. 72, Suppl. IV,
18 polyarteritis nodosa: PAN KussmaulMaier microscopic polyangiitis: MPA Churg-Strauss MPAPAN PAN..MPA PAN B PAN PAN MPA Arkin 9 :HE, :Elastica-Masson 1336 Circulation Journal Vol. 72, Suppl. IV, 2008
19 Arkin PAN PAN cpan CRP BUN ANCA PAN ANCA HBs PAN BHB PAN HBs PAN PAN MRA Circulation Journal Vol. 72, Suppl. IV,
20 PAN BVASBirmingham Vasculitis Activity ScoreFFSFive Factor Score PAN 15 PAN MPA ANCA MPA Chapel Hill Consensus ConferenceCHCC PAN PAN bc b CHB bc 10.mg/ kg/mg/ kg definite 2 probable a2 b ,000/L 400,000/L CRP 6 SLERA mg/+ml/..mg/kg/ CYintravenous cyclophosphamide: IVCYCY.mg/kg/ IVCY CY mg/kg/mgmg/ ml IVCY / IVCY CY 1338 Circulation Journal Vol. 72, Suppl. IV, 2008
21 HB MP mg/ 3 2 : PSL mg/kg/ PSL 0.5 1mg/kg/ HB IVCY 10 15mg/kg/1,4 6 CY 0.5 2mg/kg/ MP: methylprednisolone, PSL prednisolone, IVCY: intravenous cyclophosphamide, CY: cyclophosphamide, bc16 IVCY IVCY CY bc b C HB bc Cr < 3.4mg/dl Cr > 3.4mg/dl 60 15mg/kg/pulse 12.5mg/kg/pulse mg/kg/pulse 10mg/kg/pulse 70 10mg/kg/pulse 7.5mg/kg/pulse /: sikkan/ i.htm mg/ bccy b C Circulation Journal Vol. 72, Suppl. IV,
22 PAN CMV ST / / -,-D- P. jirovecii / CMV CMV CMV CMV B mg mg/ PAN b C HB PAN, ANCA MPOMPO-ANCA ANCA 1340 Circulation Journal Vol. 72, Suppl. IV, 2008
23 MPO-ANCA 2CRP 3BUN 4X 1definite a2 b MPO-ANCA 2probable a3 b1 MPO-ANCA 1PN 2Wegener 3Churg-Strauss 4Goodpasture MPO-ANCA 4 p., Wegener ELK Wegener WoudeCProteinase ANCA ANCA Sequence E LX K ELK CPR-ANCA 18 Circulation Journal Vol. 72, Suppl. IV,
24 1 1E E: 2L L: 3K K ELK proteinase 3PR3ANCA cytoplasmic patternc-anca 1definite 1ELK3 2 ELK ELK c-pr3 -ANCA 2probable 1ELK2 2 ELK ELK1c-PR3-ANCA 1CRP 2BUN 1EL 2Churg-Strauss 1 ELKEL 2 2 ELK 3EL 4EL CTMRI 5PR3-ANCA Churg-Strauss T 1342 Circulation Journal Vol. 72, Suppl. IV, 2008
25 19 Churg-Strauss PN Churg- Strauss definite Churg-Strauss 2probable Churg-Strauss 11/ 240/ 3IgE600U/m 4MPO-ANCA ,000g/m 23 3X Circulation Journal Vol. 72, Suppl. IV,
26 IgA IgA 20 IgMIgG IgMIgG IgGIgG HCV Raynaud NSAIDs / 1344 Circulation Journal Vol. 72, Suppl. IV, 2008
27 IgM IgG IgA, light chain IgMRF Ig IgMRF Ig ABC SLERAPNSjögren RA MRA, RA MRA RA PN EA RA IgG 22 D- Circulation Journal Vol. 72, Suppl. IV,
28 RA MRA AB 2 RAHA RAPA2,560RF960IU/ml X 2 C3C4 CH50 2C1q A 3 1A 1 BMRA MCTD 1346 Circulation Journal Vol. 72, Suppl. IV, 2008
2 章 +αの 情 報 に 着 目 する! 1 血 球 算 定 検 査 結 果 2 生 化 学 検 査 結 果 手 がかりに 乏 しいのも+α 1 症 例 をみてみよう! 1 60 吉 見 祐 輔 1 2 11percutaneous coronary intervention PCI104 38.
2 章 +αの 情 報 に 着 目 する! 1 血 球 算 定 検 査 結 果 2 生 化 学 検 査 結 果 手 がかりに 乏 しいのも+α 1 症 例 をみてみよう! 1 60 吉 見 祐 輔 1 2 11percutaneous coronary intervention PCI104 38.1 130 75mmHg 83 16 SpO 297 1 3 WBCL RBC10 4 L Hb g
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17 2005/12/28 UP 3+, TP 4.2g/dl, Alb 1.9g/dl PSL 50mg/day 1/17 PSL 45mg/day PSL 2006/4/4 PSL 30mg/day mpsl mpsl1000mg 32 5/8 36.1 :90 /:114/64 mmhg 166.2 cm64.3 kg 3.9 g/dl 1.6 g/dl 382 mg/dl 408 mg/dl
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