摘要
To the Editor:In September of 2016,a 26-year-old farmer from Yunnan Province with no medical or drug history exhibited painless cutaneous nodules on his chest.Later the nodules gradually appeared on his limbs,face,and trunk.After half a month,he had moderate to high-grade fever(39.5°C)and numbness of limbs.He reported no coughing,diarrhea,arthralgia,and myalgia.There was no similar illness in his family.Laboratory tests in a local hospital showed elevated white blood cell and neutrophil count.Serology tests for infection were negative.Antineutrophil cytoplasmic antibodies(ANCA)and myeloperoxidase ANCA(MPO-ANCA)were positive.The computed tomography of chest was normal.Based on the clinical and laboratory manifestations,he was diagnosed as ANCA-associated vasculitis(AAV)and was initially treated with intravenous methylprednisolone 80 mg/day and cyclophosphamide(0.4 g/2 weeks)for four times in the local hospital.In the course of the treatment,fever and skin nodules were temporarily relieved,but reoccurred when prednisone tapered to 20 to 30 mg/day.The recurrent fever,skin nodules,and numbness of limbs had lasted for 2 years,and thus,he was referred to the Sichuan University West China Hospital.
