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肉芽肿性多血管炎

Granulomatosis With Polyangiitis

作者信息

Rout Preeti, Garlapati Priyatha, Qurie Ahmad

机构信息

Wilson Case Western University

LSU Health Shreveport

Abstract

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a necrotizing vasculitis affecting small to medium-sized vessels. GPA is part of a spectrum of disorders known as antineutrophil cytoplasmic antibody (ANCA)–associated vasculitides. The 3 main ANCA-associated vasculitides are GPA, microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA or Churg-Strauss syndrome). This classification was established at the 2012 Chapel Hill Consensus Conference on the Nomenclature of Systemic Vasculitides. GPA is characterized by a pulmonary-renal syndrome associated with otorhinolaryngological manifestations.  The first case of GPA was described by German medical student Heinz Klinger in 1931. In 1936, a German pathologist, Friedrich Wegener, described 3 cases of peculiar small-medium vessel vasculitis with granulomatous inflammation and identified the disorder as a distinct form of vasculitis. In 1954, Godman and Churg published a review involving 22 cases, and the disease was universally known as Wegener's granulomatosis. In 1989, Wegener was awarded a Master Clinician Prize by the American College of Chest Physicians. In 2000, Wegener's Nazi ties came to light, and a movement began to rename the disease in the clinical community. The board of directors of the American College of Rheumatology (ACR), the American Society of Nephrology, and the European League Against Rheumatism recommended a switch to disease-descriptive nomenclature. Hence, the disease was renamed GPA. Please see StatPearls' companion resources, "ANCA Positive Vasculitis," "Microscopic Polyangiitis," and "Eosinophilic Granulomatosis with Polyangiitis," for more information.

摘要

肉芽肿性多血管炎(GPA),以前称为韦格纳肉芽肿,是一种影响中小血管的坏死性血管炎。GPA是抗中性粒细胞胞浆抗体(ANCA)相关血管炎谱系疾病的一部分。3种主要的ANCA相关血管炎是GPA、显微镜下多血管炎(MPA)和嗜酸性肉芽肿性多血管炎(EGPA或Churg-Strauss综合征)。这种分类是在2012年关于系统性血管炎命名的查珀尔希尔共识会议上确定的。GPA的特征是伴有耳鼻咽喉科表现的肺肾综合征。GPA的首例病例由德国医科学生海因茨·克林格于1931年描述。1936年,德国病理学家弗里德里希·韦格纳描述了3例伴有肉芽肿性炎症的特殊中小血管血管炎病例,并将该疾病确定为一种独特的血管炎形式。1954年,戈德曼和丘格发表了一篇涉及22例病例的综述,该疾病被普遍称为韦格纳肉芽肿。1989年,韦格纳被美国胸科医师学会授予临床大师奖。2000年,韦格纳与纳粹的关系被曝光,临床界开始了一场为该疾病重新命名的运动。美国风湿病学会(ACR)、美国肾脏病学会和欧洲抗风湿病联盟的董事会建议改用描述性疾病命名法。因此,该疾病被重新命名为GPA。有关更多信息,请参阅StatPearls的配套资源“ANCA阳性血管炎”、“显微镜下多血管炎”和“嗜酸性肉芽肿性多血管炎”。

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