Kayatas Semra, Asoglu Mehmet Resit, Selcuk Selcuk, Sargin Mehmet Akif
Department of Obstetrics and Gynecology, Zeynep Kamil Hospital, Istanbul, Turkey.
Bull NYU Hosp Jt Dis. 2012;70(2):127-9.
Pregnancy in patients with Wegener's granulamotosis (WG) is rare, and differential diagnosis of WG flare and preeclampsia is difficult.
A pregnant 35 year old with WG was referred with diagnosis of severe preeclampsia; caesarean section was performed. Intubation of the patient was difficult due to subglottic stenosis. Because of the clinical symptom, the case was considered preeclampsia, but p-ANCA of the patient was positive. In pregnancies with WG, differential diagnosis of WG flare-ups from preeclampsia should be made from clinical symptoms and laboratory findings. Serum ANCA titers are not useful in the differential diagnosis of WG flare-ups and preeclampsia because it may be positive in preeclampsia.
Differential diagnosis of WG flare-up and preeclampsia should be made by clinical features. In the patients with subglottic stenosis, general anesthesia should not be preferred due to the probability of difficult intubation.
韦格纳肉芽肿病（WG）患者怀孕较为罕见，且WG病情复发与子痫前期的鉴别诊断困难。
一名35岁患有WG的孕妇因重度子痫前期被转诊；进行了剖宫产。由于声门下狭窄，患者插管困难。鉴于临床症状，该病例被诊断为子痫前期，但患者的抗中性粒细胞胞浆抗体（p-ANCA）呈阳性。在患有WG的孕妇中，应根据临床症状和实验室检查结果对WG病情复发与子痫前期进行鉴别诊断。血清ANCA滴度在WG病情复发与子痫前期的鉴别诊断中并无帮助，因为子痫前期也可能呈阳性。
应根据临床特征对WG病情复发与子痫前期进行鉴别诊断。对于有声门下狭窄的患者，由于存在插管困难的可能性，不应首选全身麻醉。
