De All Jorge, Koutnouyan Gabriel, Herrando Sergio, Diez Eduardo, Olmedo Gloria, Gnocchi Cesar
Servicio de Clínica Médica, Sanatorio Otamendi Miroli, Buenos Aires.
Medicina (B Aires). 2011;71(1):42-4.
Wegener's granulomatosis (WG) forms part of a group of primary vasculitis of the small and medium-sized blood vessels, associated with antineutrophil cytoplasmic antibodies (ANCA). This disease may affect any body organ, especially the upper and lower airways and the kidneys. Hardly ever is otomastoiditis the first and only clinical manifestation of generalized Wegener's granulomatosis. We present the case of a patient whose disease started with the inflammation of the middle ear, which was unresponsive to the usual treatment. Later he developed nasal, pulmonary and renal compromise. The determination of ANCA and a transbronchial biopsy confirmed the diagnosis of WG. We report this case to express the view that otomastoiditis in adults, which is refractory to the usual treatment, may seldom be the first and only clinical manifestation of WG.
韦格纳肉芽肿（WG）是一组与抗中性粒细胞胞浆抗体（ANCA）相关的中小血管原发性血管炎的一部分。这种疾病可累及身体任何器官，尤其是上、下呼吸道和肾脏。耳乳突炎几乎从未作为全身性韦格纳肉芽肿的首发及唯一临床表现。我们报告一例患者，其疾病始于中耳炎症，常规治疗无效。随后，他出现了鼻腔、肺部和肾脏损害。ANCA检测及经支气管活检确诊为韦格纳肉芽肿。我们报告此病例是为了表明，常规治疗无效的成人耳乳突炎很少会是韦格纳肉芽肿的首发及唯一临床表现。
