Hervier B, Pagnoux C, Renaudin K, Masseau A, Pottier P, Planchon B, Guillevin L, Hamidou M
Service de médecine interne, CHU Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex, France.
Rev Med Interne. 2006 Jun;27(6):453-7. doi: 10.1016/j.revmed.2006.03.004. Epub 2006 Apr 5.
Endobronchial stenoses are rare in the course of Wegener's granulomatosis, and they occur even more rarely than subglottic stenoses.
We report seven cases of endobronchial stenoses in the setting of Wegener granulomatosis. Neither the pulmonary symptoms nor the systemic manifestations of vasculitis were specific. However 6/7 patients presented a wheezing or an hemoptysis. Bronchial endoscopy has permitted the diagnosis in all cases. Local evolution was cicatricial and symptomatic stenosis in 3 cases (42,8%).
Thus these lesions must be research in any case of pulmonary abnormality in the course of Wegener's granulomatosis, because they may lead to a pejorative prognosis. Moreover general and local treatment must be given early (at the inflammatory stage). After this stage, the local treatments are difficult and not efficient.
支气管内狭窄在韦格纳肉芽肿病程中较为罕见,且比声门下狭窄更为少见。
我们报告了7例韦格纳肉芽肿患者出现支气管内狭窄的病例。肺部症状和血管炎的全身表现均不具有特异性。然而,7例患者中有6例出现喘息或咯血。所有病例均通过支气管内镜检查得以确诊。局部进展方面,3例(42.8%)为瘢痕性和有症状的狭窄。
因此,在韦格纳肉芽肿病程中,无论肺部异常情况如何,都必须对这些病变进行排查,因为它们可能导致预后不良。此外,必须尽早给予全身和局部治疗(在炎症阶段)。在此阶段之后,局部治疗困难且效果不佳。