Rusterholz D, Schlegel C
Klinik für Hals-, Nasen- und Ohrenkrankheiten, Hals- und Gesichtschirurgie, Kantonsspital Luzern.
Schweiz Med Wochenschr. 2000;Suppl 125:41S-43S.
Because of manifestation of Wegener's granulomatosis in the upper respiratory tract the ENT-specialist is often initially involved in diagnosis. Recent research results suppose the chronic nasal carriage of Staphylococcus aureus triggering relapse rate in Wegener's granulomatosis. The adequate therapy of this bacteria as chronic nasal carriage may reduce the number of relapses in patients with Wegener's granulomatosis in remission.
An illustrative case report shows the positive effect of prolonged treatment with cotrimoxazole in a 49-year-old male with a second relapse of Wegener's granulomatosis.
The prolonged treatment of cotrimoxazole reduced the dose of cyclophosphamid and glucocorticoids which show long-term side effects.
15 years ago a positive effect of cotrimoxazole to Wegener's granulomatosis was discussed. Later immunological and clinical studies confirmed this fact. Prolonged treatment with cotrimoxazole seems to reduce the number of relapses in patients with this chronic disease. Corresponding with our case reduction of the systemic therapy with cyclophosphamid and glucocorticoids is possible.
由于韦格纳肉芽肿在上呼吸道的表现，耳鼻喉科专家常常首先参与诊断。最近的研究结果推测金黄色葡萄球菌的慢性鼻腔携带会引发韦格纳肉芽肿的复发率。针对这种作为慢性鼻腔携带菌的充分治疗可能会减少处于缓解期的韦格纳肉芽肿患者的复发次数。
一份典型病例报告显示，对一名韦格纳肉芽肿第二次复发的49岁男性长期使用复方新诺明治疗具有积极效果。
长期使用复方新诺明治疗减少了环磷酰胺和糖皮质激素的剂量，而这两种药物具有长期副作用。
15年前就讨论过复方新诺明对韦格纳肉芽肿的积极作用。后来的免疫学和临床研究证实了这一事实。长期使用复方新诺明似乎能减少这种慢性病患者的复发次数。与我们的病例相符，减少环磷酰胺和糖皮质激素的全身治疗是可行的。
