Ríhová Z, Merta M, Rysavá R, Bezdícek P, Danzig V, Gorican K, Lukás J, Skalická P, Vernerová Z, Tesar V
I. interní klinika 1. LF UK a VFN, Praha.
Cas Lek Cesk. 2001 Aug;140(16):503-5.
This is a case report of a patient with Wegener's granulomatosis (WG), who initially presented with a corneal perforation. In addition to the eye involvement, the pauciimmune necrotizing glomerulonephritis with crescent formation, E.N.T. and pulmonary involvement were diagnosed. The patient also suffered from the acute myocardial infarction, most likely due to coronal arteritis. In addition to the coronal ischaemia she also had vasculitis of the aortic valve due to the WG. Another rare complication was the massive intestinal bleeding. The patient had also a skin vasculitis and non-specific symptoms such as artralgias and fever. The correct diagnosis was supported by positive cANCA. A clinical and laboratory remission of the disease was achieved by combined immunosuppressive therapy. Subsequently, she developed a subglotic stenosis possibly due to reparative changes.
这是一例韦格纳肉芽肿(WG)患者的病例报告,该患者最初表现为角膜穿孔。除眼部受累外,还诊断出伴有新月体形成的寡免疫坏死性肾小球肾炎、耳鼻喉及肺部受累。患者还患有急性心肌梗死,很可能是由于冠状动脉炎所致。除了冠状动脉缺血外,她还因WG患有主动脉瓣血管炎。另一个罕见的并发症是大量肠道出血。患者还患有皮肤血管炎以及关节痛和发热等非特异性症状。抗中性粒细胞胞浆抗体(cANCA)阳性支持了正确诊断。联合免疫抑制治疗使疾病实现了临床和实验室缓解。随后,她可能由于修复性改变出现了声门下狭窄。