Fallows G A, Hamilton S F, Taylor D S, Reddy S B
St Clare's Mercy Hospital, St John's, Newfoundland, Canada.
Can J Gastroenterol. 2000 May;14(5):449-51. doi: 10.1155/2000/423569.
Wegener's granulomatosis is characterized by a granulomatous arteritis involving the upper and lower respiratory tracts, progressive glomerulonephritis and systemic symptoms attributable to small vessel vasculitis. Although multisystemic manifestations are frequent, involvement of the gastrointestinal tract is uncommon. Cases have been reported of intestinal perforation, ulceration and hemorrhage. A patient whose initial presentation of Wegener's granulomatosis was odynophagia secondary to esophageal vasculitis is described. Endoscopy revealed multiple punched out ulcerations in the esophagus, which resolved with standard therapy for systemic Wegener's granulomatosis. There are only two previous reports of symptomatic esophageal vasculitis in patients with Wegener's granulomatosis. These reports illustrate the need to consider odynophagia as a reflection of disease activity as opposed to complications of immunosuppressive therapy.
韦格纳肉芽肿病的特征是累及上、下呼吸道的肉芽肿性动脉炎、进行性肾小球肾炎以及归因于小血管血管炎的全身症状。虽然多系统表现很常见，但胃肠道受累并不常见。已有肠道穿孔、溃疡和出血的病例报道。本文描述了一名最初表现为食管血管炎继发吞咽痛的韦格纳肉芽肿病患者。内镜检查显示食管有多个穿孔性溃疡，经系统性韦格纳肉芽肿病的标准治疗后溃疡得以缓解。之前仅有两篇关于韦格纳肉芽肿病患者出现症状性食管血管炎的报道。这些报道表明，需要将吞咽痛视为疾病活动的反映，而非免疫抑制治疗的并发症。
