Great Western Hospital, Swindon, UK
Great Western Hospital, Swindon, UK.
Clin Med (Lond). 2021 Jan;21(1):79-80. doi: 10.7861/clinmed.2020-0793.
We present the case of a 71-year-old woman with bilateral pneumonia who continued to deteriorate despite multiple courses of antibiotics. When dexamethasone was added to cover the possibility of COVID-19 pneumonia, she rapidly improved. Subsequently, she was found to have a strongly positive PR3 anti-nuclear cytoplasmic antibody (ANCA) and clinical features consistent with granulomatosis with polyangiitis (GPA) with upper respiratory tract and renal involvement. The case highlights how the COVID-19 pandemic can create new challenges in the diagnosis of GPA.
我们报告了一例 71 岁女性双侧肺炎患者，尽管使用了多种抗生素，但病情仍持续恶化。当加用地塞米松覆盖 COVID-19 肺炎的可能性时，她的病情迅速改善。随后，发现她的髓过氧化物酶抗中性粒细胞胞质抗体（PR3-ANCA）呈强阳性，且具有上呼吸道和肾脏受累的 GPA 临床特征。该病例强调了 COVID-19 大流行如何在 GPA 的诊断中带来新的挑战。
