Division of Rheumatology, Department of Internal Medicine, School of Medicine, Eskişehir Osmangazi University, 26480, Eskisehir, Turkey.
Department of Radiology, Eskişehir Osmangazi University, Eskisehir, Turkey.
Rheumatol Int. 2018 Jun;38(6):1131-1138. doi: 10.1007/s00296-018-4027-z. Epub 2018 Apr 9.
Granulomatosis with polyangiitis (GPA) involves upper and lower respiratory tracts and kidneys. Lung involvement is among the most important organ involvements in GPA. GPA's lung involvement might be confused with other granulomatous conditions with lung involvement. In this report, we presented clinical features of two cases with GPA who had been diagnosed as tuberculosis (TBC) and well treated with anti-tuberculosis (anti-TBC) drugs. However, one of two cases had ear-nose-throat (ENT) manifestations before the diagnosis of TBC and her extrapulmonary findings related with GPA have added to clinical features in the following years. In the second case, the manifestations of GPA appeared after 13 months of anti-TBC treatment. We speculated that lung involvement in these cases may be due to GPA rather than TBC. Our aim was to highlight difficulties in the differential diagnosis between GPA and TBC and suggest the possible beneficial effect of anti-TBC drugs on the lung involvement due to GPA in light of the literature data.
肉芽肿性多血管炎（GPA）涉及上呼吸道和下呼吸道以及肾脏。肺部受累是 GPA 最重要的器官受累之一。GPA 的肺部受累可能与其他伴有肺部受累的肉芽肿性疾病相混淆。在本报告中，我们介绍了两例 GPA 患者的临床特征，他们被诊断为结核病（TBC）并接受了抗结核（抗-TBC）药物的良好治疗。然而，这两例患者中的一例在被诊断为 TBC 之前就有耳鼻喉（ENT）表现，并且她的肺外表现与 GPA 有关，这些表现增加了随后几年的临床特征。在第二例患者中，GPA 的表现出现在抗-TBC 治疗 13 个月后。我们推测这些病例的肺部受累可能是 GPA 而不是 TBC。我们的目的是强调 GPA 和 TBC 之间鉴别诊断的困难，并根据文献数据提示抗-TBC 药物可能对 GPA 引起的肺部受累有益。
