{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T23:19:35Z","timestamp":1778109575917,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,2,14]]},"abstract":"<jats:p>A 67-year-old woman was referred to our hospital because of gradually increasing dyspnoea on exertion for 6 months. Chest CT scan showed subpleural parenchymal fibrotic opacities with traction bronchiectasis in the bilateral upper lung fields. Serum rheumatoid factor and myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) were positive. There was no evident reason to suspect connective tissue disease such as ANCA-associated vasculitis or rheumatoid arthritis. We performed a CT-guided percutaneous needle biopsy of the subpleural lesion that showed slight uptake on the fluorodeoxyglucose-positron emission tomography (FDG-PET) CT scan. This specimen showed subpleural fibrosis as evidenced by an abnormal increase of elastic tissue and minimal collagen deposition, which indicated pleuroparenchymal fibroelastosis (PPFE). Although PPFE can be associated with a variety of causes, its association with MPO-ANCA is unknown. A CT-guided transthoracic lung biopsy caused no adverse events and was useful in the diagnosis of PPFE in our patient.<\/jats:p>","DOI":"10.1136\/bcr-2017-223287","type":"journal-article","created":{"date-parts":[[2018,2,24]],"date-time":"2018-02-24T04:55:13Z","timestamp":1519448113000},"page":"bcr-2017-223287","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Pleuroparenchymal fibroelastosis with positive MPO-ANCA diagnosed with a CT-guided percutaneous needle biopsy"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2480-6087","authenticated-orcid":false,"given":"Hideaki","family":"Yamakawa","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuneyuki","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohisa","family":"Baba","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Ogura","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,2,24]]},"reference":[{"key":"2025082801412855000_2018.feb23_1.bcr-2017-223287.1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201308-1483ST"},{"key":"2025082801412855000_2018.feb23_1.bcr-2017-223287.2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00214714"},{"key":"2025082801412855000_2018.feb23_1.bcr-2017-223287.3","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker236"},{"key":"2025082801412855000_2018.feb23_1.bcr-2017-223287.4","doi-asserted-by":"crossref","unstructured":"Yamakawa H , Takemura T , Yamanaka Y , et al . 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Role of autoantibodies in the diagnosis of connective-tissue disease ILD (CTD-ILD) and interstitial pneumonia with autoimmune features (IPAF). 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