{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:46:26Z","timestamp":1792050386192,"version":"4.4.0"},"reference-count":15,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Anti\u2010glomerular basement membrane (anti\u2010GBM) disease may coexist with antineutrophil cytoplasmic antibodies (ANCA), a clinicopathologic entity termed double\u2010positive disease, in which diffuse alveolar hemorrhage (DAH) is common but histologic confirmation of pulmonary capillaritis remains difficult. A 93\u2010year\u2010old woman presented with rapidly progressive renal failure, and serologic evaluation revealed markedly elevated myeloperoxidase (MPO)\u2010ANCA and anti\u2010GBM antibody levels. Despite corticosteroid therapy, the patient died of progressive renal failure. At autopsy, the kidneys demonstrated diffuse crescentic glomerulonephritis with linear IgG deposition along the glomerular basement membrane, consistent with anti\u2010GBM nephritis, together with multiple cortical scars composed of clusters of globally sclerotic glomeruli and interstitial fibrosis. The lungs exhibited DAH with focal neutrophilic infiltration along the alveolar septa, accompanied by focal destruction of capillary walls with subtle leukocytoclasia. Immunohistochemical analysis using epithelial marker (cytokeratin AE1\/AE3), endothelial markers (CD31, CD34, and ERG), and platelet markers (CD61 and CD42b) highlighted alveolar epithelial injury, loss of endothelial continuity, and extravascular platelet deposition, respectively, in areas where capillaritis was suspected. Spatial concordance of these findings supported the presence of structural injury associated with pulmonary capillaritis. This case highlights the diagnostic importance of rigorous histopathologic assessment complemented by combined immunohistochemistry in patients with DAH.<\/jats:p>","DOI":"10.1111\/pin.70196","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T06:51:06Z","timestamp":1792047066000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Histopathologic Assessment of Pulmonary Capillaritis Using Combined Immunohistochemical and Special Stains: An Autopsy Case Double\u2010Positive for MPO\u2010ANCA and Anti\u2010GBM Antibodies"],"prefix":"10.1111","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0778-8238","authenticated-orcid":false,"given":"Mari","family":"Watanabe","sequence":"first","affiliation":[{"name":"Department of Diagnostic Pathology Asahi General Hospital Asahi Chiba Japan"},{"name":"Department of Diagnostic Pathology, Institute of Medicine University of Tsukuba Tsukuba Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3379-2707","authenticated-orcid":false,"given":"Shun","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Asahi General Hospital Asahi Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Department of Nephrology Asahi General Hospital Asahi Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-6840","authenticated-orcid":false,"given":"Daisuke","family":"Matsubara","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology, Institute of Medicine University of Tsukuba Tsukuba Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0460-064X","authenticated-orcid":false,"given":"Masashi","family":"Fukayama","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology Asahi General Hospital Asahi Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.jaut.2014.01.024","article-title":"Diagnosis and Classification of Goodpasture's Disease (Anti\u2010GBM)","volume":"48","author":"Hellmark T.","year":"2014","journal-title":"Journal of Autoimmunity"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1111\/j.1523-1755.2004.00917.x","article-title":"Clinical Features and Outcome of Patients With Both ANCA and Anti\u2010GBM Antibodies","volume":"66","author":"Levy J. 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