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两例表现为MPO-ANCA相关疾病的矽肺病例

[Two cases of silicosis exhibiting MPO-ANCA associated disorder].

作者信息

Kourakata H, Saeki T, Miyamura S, Suzuki E, Nakano M, Gejyo F, Arakawa M

机构信息

Department of Internal Medicine, Nagaoka Red Cross Hospital, Niigata.

出版信息

Ryumachi. 1999 Dec;39(6):841-6.

Abstract

We reported two cases of silicosis exhibiting MPO-ANCA associated disorder. Case 1 was a 69 year-old man with silicosis and chronic interstitial pneumonia. He was admitted because of fever, dry cough, left chest pain, dyspnea and body weight loss. He was diagnosed as acute exacerbation of interstitial pneumonia, pericarditis and gastrointestinal bleeding. Case 2 was a 67 year-old man with silicosis. He repeated attack of fever, hoarseness, dysphagia and headache. The cell counts of cerebrospinal fluid increased and the thickness of cerebellar tent and left dura mater was observed in the brain MRI. Therefore, he was diagnosed as pachymeningitis and neuropathy of cranial nerves. Both cases were complicated by silicosis and the laboratory findings showed high serum levels of P-ANCA, ANA and rheumatoid factor and inflammatory responses, indicating they were suspected vasculitis. The two cases were treated by steroid and immunosuppressive therapy and had good clinical response. Silicosis may affect multiple organ involvement associated with P-ANCA.

摘要

我们报告了两例表现为MPO - ANCA相关疾病的矽肺病例。病例1是一名69岁患有矽肺和慢性间质性肺炎的男性。他因发热、干咳、左胸痛、呼吸困难和体重减轻入院。他被诊断为间质性肺炎急性加重、心包炎和胃肠道出血。病例2是一名67岁患有矽肺的男性。他反复出现发热、声音嘶哑、吞咽困难和头痛。脑脊液细胞计数增加,脑部MRI观察到小脑幕和左硬脑膜增厚。因此,他被诊断为硬脑膜炎和颅神经病变。两例均合并矽肺,实验室检查结果显示血清P - ANCA、ANA和类风湿因子水平升高以及炎症反应,提示疑似血管炎。这两例均接受了类固醇和免疫抑制治疗,临床反应良好。矽肺可能会影响与P - ANCA相关的多器官受累。

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