Kamar Nassim, Malavaud Bernard, Alric Laurent, le Mao Gildas, Mazerolles Catherine, Duffaut Michel, Sarramon Jean Pierre, Pourrat Jacques
Department of Nephrology, CHU Toulouse-Purpan, Toulouse, France.
Urology. 2003 Aug;62(2):352. doi: 10.1016/s0090-4295(03)00368-6.
In Wegener's granulomatosis, necrotizing lesions are typically located in the upper and lower respiratory tract and kidneys, and ureteral involvement is uncommon. We report 2 cases in which intrinsic ureteral stenosis was the sole manifestation of this small-vessel vasculitis. Excisional surgery evidenced characteristic granulomatous inflammation that allowed adjuvant elective medical treatment. Urologists, nephrologists, and internists should be aware of this atypical presentation of Wegener's granulomatosis. Thorough clinical and biologic assessments are warranted in the initial workup of isolated intrinsic ureteral stenosis.
在韦格纳肉芽肿病中，坏死性病变通常位于上、下呼吸道及肾脏，输尿管受累并不常见。我们报告2例以输尿管固有狭窄作为这种小血管血管炎唯一表现的病例。切除手术证实存在特征性的肉芽肿性炎症，从而可行辅助性选择性药物治疗。泌尿外科医生、肾内科医生及内科医生应认识到韦格纳肉芽肿病的这种非典型表现。对于孤立性输尿管固有狭窄的初始检查，进行全面的临床及生物学评估是必要的。
