Ketata W, Msaad S, Gharsalli H, Kammoun K, Abid T, Mrabet S, Makni S, Boudawara T, Ayoub A
Service de Pneumo-allergologie, CHU Hédi Chaker, Sfax, Tunisie.
Rev Mal Respir. 2009 Nov;26(9):981-4. doi: 10.1016/s0761-8425(09)73333-9.
Pulmonary fibrosis secondary to antineutrophil cytoplasmic antibodypositive vasculitis is rarely reported. Most cases have occurred in association with microscopic polyangiitis.
We report the case of an 82-year-old man presenting with pulmonary fibrosis. The CT scan showed honeycombing and traction bronchiectasis with peripheral and basal predominance. The diagnosis of Wegener's granulomatosis was based on the association of positive antineutrophil cytoplasmic antibodies, urinary sediment abnormalities and renal biopsy findings.
We emphasize, through this case, the rarity of interstitial fibrosis as a pulmonary manifestation of vasculitis and we discuss the pathogenesis of this association.
抗中性粒细胞胞浆抗体阳性血管炎继发的肺纤维化鲜有报道。大多数病例与显微镜下多血管炎相关。
我们报告一例82岁男性肺纤维化病例。CT扫描显示蜂窝状改变和牵拉性支气管扩张,以外周和基底部分为主。韦格纳肉芽肿的诊断基于抗中性粒细胞胞浆抗体阳性、尿沉渣异常及肾活检结果。
通过该病例,我们强调间质性纤维化作为血管炎肺部表现的罕见性,并讨论这种关联的发病机制。