Kishimoto Mitsumasa, Arakawa Ken C
University of Hawaii Internal Medicine Residency Program, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA.
J Clin Rheumatol. 2003 Dec;9(6):354-8. doi: 10.1097/01.rhu.0000089967.51779.d7.
We report a case of intraventricular hemorrhage (IVH) in a 27-year-old man with Wegener granulomatosis (WG), successfully treated with corticosteroids and cyclophosphamide. Neurologic manifestations occur in 22%-54% of patients with WG, with cerebral vasculitis in less than 5%. Only 2 cases of IVH associated with WG have been reported at autopsy. This is the first reported case of in situ IVH associated with WG in a patient who survived. In patients with WG who present with neurologic manifestations, cerebral vasculitis with secondary intracranial hemorrhage should be considered, as these patients are often resistant to immunosuppressive therapies and may present with normal angiograms.
我们报告一例27岁患有韦格纳肉芽肿(WG)的男性发生脑室内出血(IVH),经皮质类固醇和环磷酰胺成功治疗。WG患者中22%-54%会出现神经系统表现,其中不到5%有脑血管炎。尸检报告中仅2例IVH与WG相关。这是首例报告的与WG相关的原位IVH存活患者病例。对于出现神经系统表现的WG患者,应考虑继发颅内出血的脑血管炎,因为这些患者通常对免疫抑制治疗耐药,血管造影可能正常。