Department of Dermatology and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.
Department of Dermatology and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.
An Bras Dermatol. 2021 Mar-Apr;96(2):240-242. doi: 10.1016/j.abd.2020.06.009. Epub 2021 Jan 30.
Small vessel vasculitis with anti-proteinase antibodies 3 is an atypical clinical presentation of tuberculosis. The authors present the case of a 47-year-old male patient, with palpable purpura and palmoplantar hemorrhagic blisters, with subsequent dissemination. He presented severe pulmonary symptoms with cavitation, fever, hemoptysis, and high levels of anti-proteinase 3. Histopathological assessment of the skin revealed small vessel vasculitis; pulmonary histopathology showed granulomas with caseation. Bronchoalveolar lavage was positive for alcohol-acid-fast bacilli. In countries with a high prevalence of tuberculosis, the presence of autoantibodies in a patient with vasculitis, fever, and pulmonary cavitation requires investigation of infectious causes.
抗蛋白酶 3 相关的小血管血管炎为结核病的一种非典型临床表现。作者报告了 1 例 47 岁男性患者，表现为可触及紫癜和手掌-足底出血性水疱，随后扩散。患者有严重的肺部症状，有空洞形成、发热、咯血和高水平的抗蛋白酶 3。皮肤的组织病理学评估显示小血管血管炎；肺部组织病理学显示干酪样坏死性肉芽肿。支气管肺泡灌洗液抗酸杆菌阳性。在结核病高发的国家，当血管炎、发热和肺部空洞的患者存在自身抗体时，需要调查感染原因。
