Yamashita Hiroyuki, Takahashi Yuko, Kaneko Hiroshi, Kano Toshikazu, Mimori Akio
Division of Rheumatic Diseases, National Center for Global Health and Medicine, Japan.
Intern Med. 2014;53(7):801-4. doi: 10.2169/internalmedicine.53.1599. Epub 2012 Mar 1.
We herein report the case of a 72-year-old woman with diffuse cutaneous systemic sclerosis (SSc) complicated by antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis who exhibited honeycomb lung without volume loss. On admission, chest computed tomography (CT) revealed honeycomb lung without volume loss in addition to increased density of the partition walls. A renal biopsy revealed global sclerosis and cellular crescent formation. Mononeuritis multiple subsequently occurred, and steroid pulse therapy with cyclophosphamide was administered. Repeat chest CT showed that the honeycomb lung was unchanged; however, overall reduced density of the partition walls was observed. It is necessary to recognise that vasculitis may develop in SSc patients who exhibit honeycomb lung without volume loss.
我们在此报告一例72岁女性,患有弥漫性皮肤系统性硬化症(SSc),并发抗中性粒细胞胞浆抗体(ANCA)相关血管炎,表现为蜂窝肺且无肺容积减少。入院时,胸部计算机断层扫描(CT)显示除间隔增厚外,还有无肺容积减少的蜂窝肺。肾活检显示全球硬化和细胞性新月体形成。随后发生了多发性单神经炎,并给予了环磷酰胺冲击治疗。重复胸部CT显示蜂窝肺无变化;然而,观察到间隔的整体密度降低。有必要认识到,在表现为无肺容积减少的蜂窝肺的SSc患者中可能会发生血管炎。