NEJM:肉芽肿合并多血管炎所致鼻畸形-病例报道

2020-03-05 xing.T MedSci原创

该患者被诊断为肉芽肿性多血管炎,并开始免疫抑制治疗这种ANCA相关性血管炎。随访6个月,患者的症状有所减轻,复查CT显示肺结节消退,面部结构稳定。

患者为一名42岁的男性,因咳嗽、呼吸急促和发热恶化而就诊,在过去4年中接受过多次鼻窦炎治疗。他没有可卡因接触史。

体格检查显示鞍型鼻畸形(如图A所示),鼻黏膜发炎,鼻部结痂。肺部听诊两肺都可听到喘息声和罗音。



胸部计算机断层扫描(CT)发现多个肺结节,面部CT扫描发现中脸结构骨骼的广泛破坏,导致形成较大的鼻腔(如图B所示),蛋白酶3抗中性粒细胞胞浆抗体(ANCA)检测呈阳性。

该患者被诊断为肉芽肿性多血管炎,并开始免疫抑制治疗这种ANCA相关性血管炎。随访6个月,患者的症状有所减轻,复查CT显示肺结节消退,面部结构稳定。

原始出处:

Federica Bello,,et al.Nasal Deformity in Granulomatosis with Polyangiitis.N Engl J Med 2020;https://www.nejm.org/doi/full/10.1056/NEJMicm1909658

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    2021-01-24 zz70
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    2020-03-06 wushaoling
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  6. [GetPortalCommentsPageByObjectIdResponse(id=2009799, encodeId=1c8f2009e9926, content=<a href='/topic/show?id=95f2103480ce' target=_blank style='color:#2F92EE;'>#鼻畸形#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103480, encryptionId=95f2103480ce, topicName=鼻畸形)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30f5146, createdName=zz70, createdTime=Sun Jan 24 20:42:00 CST 2021, time=2021-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263242, encodeId=d8d3126324273, content=<a href='/topic/show?id=581e8968859' target=_blank style='color:#2F92EE;'>#血管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89688, encryptionId=581e8968859, topicName=血管炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=909c71, createdName=shijzhiewnjhch, createdTime=Fri Mar 06 23:42:00 CST 2020, time=2020-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1344787, encodeId=fab41344e87ef, content=<a href='/topic/show?id=0e98808e9f9' target=_blank style='color:#2F92EE;'>#肉芽肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80879, encryptionId=0e98808e9f9, topicName=肉芽肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=09a12500213, createdName=12498f1em08(暂无昵称), createdTime=Fri Mar 06 23:42:00 CST 2020, time=2020-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1362325, encodeId=82c8136232578, content=<a href='/topic/show?id=9857e03444b' target=_blank style='color:#2F92EE;'>#畸形#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70344, encryptionId=9857e03444b, topicName=畸形)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ca20190, createdName=wushaoling, createdTime=Fri Mar 06 23:42:00 CST 2020, time=2020-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545896, encodeId=cd08154589669, content=<a href='/topic/show?id=f5e743450aa' target=_blank style='color:#2F92EE;'>#多血管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43450, encryptionId=f5e743450aa, topicName=多血管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b6013824614, createdName=12498bf3m29暂无昵称, createdTime=Fri Mar 06 23:42:00 CST 2020, time=2020-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035158, encodeId=a22010351584c, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Mar 05 11:42:00 CST 2020, time=2020-03-05, status=1, ipAttribution=)]
    2020-03-05 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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