Burns P, Keogh I J, Waheed K, Timon C V I
Department of Otolaryngology/Head & Neck Surgery, Royal Victoria Eye & Ear Hospital, Adelaide Road, Dublin 2, Ireland.
Ir Med J. 2004 Feb;97(2):51.
Wegener's Granulomatosis (WG) is a rare, multi-system disease of unknown aetiology. The disease is characterised by necrotizing granulomas and vasculitis of the upper and lower respiratory tracts and kidneys. The sinonasal region may be the first area to manifest this systemic condition. If the disease is diagnosed early and treated appropriately, involvement of the lungs and kidneys may be averted. Left untreated, the disease may prove rapidly fatal. A low threshold of clinical suspicion must be maintained. We report a case, of a middle aged patient who presented with unilateral sinusitis secondary to a large obstructive nasal mass. Anti neutrophil cytoplasmic antibody (ANCA) titres helped confirm the diagnosis of WG. Unilateral sinusitis with a nasal mass, is a very unusual presentation of WG, and emphasises the importance of a low threshold of suspicion for patients presenting with atypical sinonasal symptoms.
韦格纳肉芽肿（WG）是一种病因不明的罕见多系统疾病。该疾病的特征是上、下呼吸道及肾脏出现坏死性肉芽肿和血管炎。鼻窦区域可能是这种全身性疾病首先出现症状的部位。如果疾病能早期诊断并得到适当治疗，可避免肺部和肾脏受累。若不治疗，疾病可能迅速致命。必须保持较低的临床怀疑阈值。我们报告一例中年患者，因巨大阻塞性鼻肿物继发单侧鼻窦炎前来就诊。抗中性粒细胞胞浆抗体（ANCA）滴度有助于确诊韦格纳肉芽肿。单侧鼻窦炎伴鼻肿物是韦格纳肉芽肿非常不常见的表现形式，强调了对于出现非典型鼻窦症状患者保持低怀疑阈值的重要性。
