Jonaitytė Brigita, Kibarskytė Rūta, Danila Edvardas, Miglinas Marius, Šeinin Dmitrij, Stulpinas Rokas, Mitrikevičienė Jurgita, Gruslys Vygantas, Šileikienė Virginija, Zablockis Rolandas
Faculty of Medicine of Vilnius University, Vilnius, Lithuania.
Clinic of Infectious and Chest Diseases, Dermatovenereology and Allergology of Vilnius University.
Acta Med Litu. 2016;23(2):142-146. doi: 10.6001/actamedica.v23i2.3331.
ANCA-associated vasculitis (AAV) is an inflammatory systemic disorder affecting small to medium sized vessels and likely leading to any organ dysfunction. Adequate treatment is important to avoid mortality or severe organ damage. In most cases initial treatment (induction therapy) allows to achieve remission. Induction therapy leads to immunosuppression and may cause severe infections. However, in vasculitis patients even an intensive immunosuppressive therapy is rarely complicated by an invasive fungal infection. We present a case in a 29-year old male patient with newly diagnosed AAV. He suffered a fatal pulmonary complication of the induction immunosuppressive treatment. Pathological (infectious) changes in the lungs were misinterpreted as progression of the vasculitis and he died due to disseminated angioinvasive aspergillosis. A clinical course, imaging and histopathology of this case are described and discussed.
抗中性粒细胞胞浆抗体相关性血管炎（AAV）是一种影响中小血管的炎症性全身性疾病，可能导致任何器官功能障碍。充分的治疗对于避免死亡或严重器官损害很重要。在大多数情况下，初始治疗（诱导治疗）可实现缓解。诱导治疗会导致免疫抑制，并可能引起严重感染。然而，在血管炎患者中，即使是强化免疫抑制治疗也很少并发侵袭性真菌感染。我们报告一例29岁新诊断为AAV的男性患者。他在诱导免疫抑制治疗中出现了致命的肺部并发症。肺部的病理（感染性）变化被误诊为血管炎的进展，他因播散性血管侵袭性曲霉病死亡。本文描述并讨论了该病例的临床病程、影像学和组织病理学情况。
