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韦格纳肉芽肿病患者妊娠:一例报告

Pregnancy in a patient with Wegener's granulomatosis: a case report.

作者信息

Kayatas Semra, Asoglu Mehmet Resit, Selcuk Selcuk, Sargin Mehmet Akif

机构信息

Department of Obstetrics and Gynecology, Zeynep Kamil Hospital, Istanbul, Turkey.

出版信息

Bull NYU Hosp Jt Dis. 2012;70(2):127-9.

Abstract

BACKGROUND

Pregnancy in patients with Wegener's granulamotosis (WG) is rare, and differential diagnosis of WG flare and preeclampsia is difficult.

CASE

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.

CONCLUSION

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.

摘要

背景

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。

病例

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。

结论

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。

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