Nawata Takashi, Murakawa Kaori, Shiragami Kosaku, Shibuya Masaki, Kubo Makoto, Yano Masafumi
Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Department of Internal Medicine, Sento Hill Hospital, Ube, Japan.
SAGE Open Med Case Rep. 2021 Apr 27;9:2050313X211011814. doi: 10.1177/2050313X211011814. eCollection 2021.
Diffuse alveolar haemorrhage and central nervous system vasculitis are life-threatening complications of anti-neutrophil cytoplasmic antibody-associated vasculitis. The simultaneous occurrence of diffuse alveolar haemorrhage and central nervous system vasculitis is a rare presentation of antibody-associated vasculitis. Its diagnosis by histopathology is difficult because biopsy is difficult to perform, and urgent treatment is needed. We report a case of a Japanese man with diffuse alveolar haemorrhage and central nervous system vasculitis associated with antibody-associated vasculitis. New classification criteria may be needed for diffuse alveolar haemorrhage and central nervous system vasculitis associated with systemic vasculitis. When antibiotic-resistant atypical bilateral pneumonia is noted in the acute phase of a cerebral stroke, with elements suggestive of vasculitis, clinicians should be aware that diffuse alveolar haemorrhage and central nervous system vasculitis may occur simultaneously.
弥漫性肺泡出血和中枢神经系统血管炎是抗中性粒细胞胞浆抗体相关性血管炎的危及生命的并发症。弥漫性肺泡出血和中枢神经系统血管炎同时出现是抗体相关性血管炎的一种罕见表现。通过组织病理学进行诊断很困难，因为活检难以实施，且需要紧急治疗。我们报告一例患有与抗体相关性血管炎相关的弥漫性肺泡出血和中枢神经系统血管炎的日本男性病例。对于与系统性血管炎相关的弥漫性肺泡出血和中枢神经系统血管炎，可能需要新的分类标准。当在脑卒中急性期发现耐药性非典型双侧肺炎且有提示血管炎的因素时，临床医生应意识到可能同时发生弥漫性肺泡出血和中枢神经系统血管炎。
