Division of Allergy and Clinical Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michagan, USA.
Allergy Asthma Proc. 2013 Mar-Apr;34(2):188-92. doi: 10.2500/aap.2013.34.3637.
We present a 50-year-old woman with progressive dyspnea, cough, and nasal congestion. Evaluation revealed positive skin tests (IgE) to trees and dust mites, early glottic closure on spirometry, and sinus opacities on CT. Diagnostic considerations included allergic and nonallergic rhinitis, asthma, aspirin-exacerbated respiratory disease, vocal cord dysfunction, chronic sinusitis secondary to gastroesophageal reflux disease, and systemic inflammatory and immunologic diseases, including vasculitis. Progresson of her symptoms prompted further investigation, and a biopsy yielded an unexpected diagnosis.
我们呈现一位 50 岁女性，其症状逐渐加重，包括呼吸困难、咳嗽和鼻塞。评估发现患者对树木和尘螨的皮肤试验（IgE）呈阳性，肺功能检查显示早期声门关闭，CT 显示鼻窦混浊。诊断考虑包括过敏性和非过敏性鼻炎、哮喘、阿司匹林加重的呼吸道疾病、声带功能障碍、胃食管反流病引起的慢性鼻窦炎以及系统性炎症和免疫性疾病，包括血管炎。由于症状进展，进一步进行了检查，活检结果出人意料。
