Koyama S, Murakami K, Sakakibara T, Muramatsu S, Watanabe M, Miki M, Ebina M, Nukiwa T
Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Sarcoidosis Vasc Diffuse Lung Dis. 2010 Jul;27(1):76-9.
Wegener's granulomatosis (WG) is characterized by systemic granulomatous necrotizing vasculitis, primarily affecting the respiratory tract and kidneys. We describe a rare case in a 28-year-old woman with WG, presenting with a massive lateral pleural effusion, accompanied by an aseptic bronchopleural fistula formed during immunosuppressive treatment. Although any organ can be involved in WG, only left pleuritis and a purpuric lesion on the neck were detected in this case. The pleural effusion and bronchopleural fistula resolved following immunosuppressive treatment for six months. Thus, WG should be considered in the differential diagnosis of a massive pleural effusion, and fistula formation is a possible complication of treatment. Moreover, immunosuppressive treatment was sufficient to resolve the massive pleural effusion and fistula formation without infection (120 words).
韦格纳肉芽肿病(WG)的特征是全身性肉芽肿性坏死性血管炎,主要累及呼吸道和肾脏。我们描述了一例罕见的28岁女性WG病例,该患者表现为大量胸腔积液,并在免疫抑制治疗期间形成无菌性支气管胸膜瘘。尽管WG可累及任何器官,但该病例仅检测到左侧胸膜炎和颈部紫癜样病变。经过六个月的免疫抑制治疗,胸腔积液和支气管胸膜瘘得以缓解。因此,在鉴别诊断大量胸腔积液时应考虑WG,瘘管形成是治疗的一种可能并发症。此外,免疫抑制治疗足以消除大量胸腔积液和瘘管形成,且无感染发生。