MPO and Abnormal renal physiology: In the four patients who developed MPA, two patients (Cases 7, 8) had alveolar hemorrhage, three patients (Cases 6, 7, 8) showed renal dysfunction with hematuria, two patients (Cases 5, 8) exhibited a purpuric rash with small-vessel vasculitis detected by skin biopsy, and all four patients showed positivity for myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA).