Sekine K, Nakajima Y, Sawamoto S, Yamada K, Nakajima M, Miyasaka T, Arioka H, Nakano J, Yamashita N, Ohta K, Mano K
Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Nihon Kokyuki Gakkai Zasshi. 1999 Feb;37(2):135-9.
A 39-year-old man was admitted to our hospital because of hemoptysis. A chest X-ray film on admission showed a patchy shadow in the left lower lung field. Computed tomography revealed nodular opacities in the left pulmonary artery. The patient had history of oral ulcers, erythema nodosum, pustular lesions, and genital ulcers. Furthermore, the needle reaction was positive. Our diagnosis was an incomplete type of Behcet's disease. A radionuclide-venography and lung-perfusion study disclosed deep-vein thrombosis. Combined therapy with prednisolone, colchicine, and indomethacin farnesil was initiated, but the patient died of massive hemoptysis. Pathological examination revealed a ruptured aneurysm in the bronchus segmentalis apacalis and thrombotic angitis in the inferior vena cava. Behcet's disease is rarely a cause of hemoptysis. However, the prevalence of hemoptysis due to pulmonary vasculitis in patients with Behcet's disease has been reported to be 5 to 10% which is not so rare. Because of the poor prognosis, we want to emphasize Behcet's disease as a cause of hemoptysis.
一名39岁男性因咯血入院。入院时胸部X线片显示左下肺野有斑片状阴影。计算机断层扫描显示左肺动脉有结节状混浊。该患者有口腔溃疡、结节性红斑、脓疱性病变和生殖器溃疡病史。此外,针刺反应呈阳性。我们的诊断是不完全型白塞病。放射性核素静脉造影和肺灌注研究显示有深静脉血栓形成。开始使用泼尼松龙、秋水仙碱和法尼酯吲哚美辛联合治疗,但患者死于大量咯血。病理检查显示肺段支气管动脉瘤破裂,下腔静脉有血栓性血管炎。白塞病很少是咯血的原因。然而,据报道白塞病患者因肺血管炎导致咯血的发生率为5%至10%,并非罕见。由于预后较差,我们想强调白塞病是咯血的一个原因。