{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T14:15:34Z","timestamp":1774534534325,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,3,12]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>Microscopic polyangiitis (MPA) is a primary systemic small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA). The condition is uncommon among the UK population, although it increases with age. MPA manifests heterogeneously and may affect any organ, although glomerulonephritis is almost always present. This case report describes a rare presentation of MPA with isolated mononeuritis multiplex, without glomerulonephritis or other hallmark features, and reflects the varied manifestations of MPA and challenges in recognising the condition. Awareness of MPA is essential to timely diagnosis, treatment initiation and improved health outcomes.<\/jats:p>\n                  <jats:p>\n                    <jats:named-content content-type=\"indent\">\u2003<\/jats:named-content>\n                    MPA-related neuropathy damages nerve vasculature, typically causing mononeuritis multiplex, and may predispose older adults to falls. Treatment involves managing the underlying vasculitis through immunosuppression; however, treatment complications arising from immunosuppression are common in older adults, increase with frailty and may complicate management. Therefore, a multidisciplinary approach is necessary, and an understanding of the condition from geriatric perspectives is key.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-270153","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:35:16Z","timestamp":1774532116000},"page":"e270153","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["An atypical presentation of microscopic polyangiitis without renal involvement in an older patient with falls, bilateral lower limb swelling and neuropathy"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8757-2787","authenticated-orcid":false,"given":"Molly","family":"Sun Wai","sequence":"first","affiliation":[{"name":"Department of Medicine for the Elderly, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, Essex, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Medicine for the Elderly, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, Essex, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adaeze","family":"Ugwoke","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, Essex, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"2026032606350794000_19.3.e270153.1","unstructured":"Falls: applying All Our Health. Office for Health Improvement & Disparities, UK Government . 2022. Available: https:\/\/www.gov.uk\/government\/publications\/falls-applying-all-our-health\/falls-applying-all-our-health [Accessed 21 Sep 2025]."},{"key":"2026032606350794000_19.3.e270153.2","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/jns.12656","article-title":"Peripheral neuropathy, an independent risk factor for falls in the elderly, impairs stepping as a postural control mechanism: A case-cohort study","volume":"29","author":"Kohle","year":"2024","journal-title":"J Peripher Nerv Syst"},{"key":"2026032606350794000_19.3.e270153.3","doi-asserted-by":"crossref","DOI":"10.1186\/s42466-020-00064-2","article-title":"Diagnosis of peripheral neuropathy","volume":"2","author":"Lehmann","year":"2020","journal-title":"Neurol Res Pract"},{"key":"2026032606350794000_19.3.e270153.4","first-page":"11","article-title":"Diagnosis and Treatment of Vasculitic Neuropathy","volume":"23","author":"M\u00f8ller Witt","year":"2024","journal-title":"Pract Neurol"},{"key":"2026032606350794000_19.3.e270153.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.m1070","article-title":"ANCA associated vasculitis","volume":"369","author":"Hunter","year":"2020","journal-title":"BMJ"},{"key":"2026032606350794000_19.3.e270153.6","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-018-0145-y"},{"key":"2026032606350794000_19.3.e270153.7","doi-asserted-by":"crossref","first-page":"e736","DOI":"10.1016\/S2665-9913(24)00264-9","article-title":"Reclassifying ANCA-associated vasculitis: a focus on kidney disease","volume":"6","author":"Berke","year":"2024","journal-title":"Lancet Rheumatol"},{"key":"2026032606350794000_19.3.e270153.8","doi-asserted-by":"crossref","first-page":"iii42","DOI":"10.1093\/rheumatology\/keaa089","article-title":"An update on the epidemiology of ANCA-associated vasculitis","volume":"59","author":"Mohammad","year":"2020","journal-title":"Rheumatology (Oxford)"},{"key":"2026032606350794000_19.3.e270153.9","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.m421","article-title":"Management of ANCA associated vasculitis","volume":"368","author":"Wallace","year":"2020","journal-title":"BMJ"},{"key":"2026032606350794000_19.3.e270153.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2010.07.009"},{"key":"2026032606350794000_19.3.e270153.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01736-1"},{"key":"2026032606350794000_19.3.e270153.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102495"},{"key":"2026032606350794000_19.3.e270153.13","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223764"},{"key":"2026032606350794000_19.3.e270153.14","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221796"},{"key":"2026032606350794000_19.3.e270153.15","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s40120-021-00315-7","article-title":"ANCA-Associated Vasculitic Neuropathies: A Review","volume":"11","author":"Koike","year":"2022","journal-title":"Neurol Ther"},{"key":"2026032606350794000_19.3.e270153.16","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kez388"},{"key":"2026032606350794000_19.3.e270153.17","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1007\/s40266-025-01210-8","article-title":"Aging in Granulomatosis with Polyangiitis and Microscopic Polyangiitis: From Pathophysiology to Clinical Management","volume":"42","author":"Chevet","year":"2025","journal-title":"Drugs Aging"},{"key":"2026032606350794000_19.3.e270153.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909905"},{"key":"2026032606350794000_19.3.e270153.19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909169"},{"key":"2026032606350794000_19.3.e270153.20","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1002\/acr2.11274","article-title":"Comparison of Two Rituximab Induction Regimens for Antineutrophil Cytoplasm Antibody-Associated Vasculitis: Systematic Review and Meta-Analysis","volume":"3","author":"B\u00e9nard","year":"2021","journal-title":"ACR Open Rheumatol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-270153","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T13:35:20Z","timestamp":1774532120000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-270153"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":20,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,26]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bcr-2025-270153"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-270153","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}