Iyer Sekhar, Simon Michael A, Schroeder Donald, Gesner Lyle
Department of Radiology, RWJBH - Saint Barnabas Medical Center, 94 Old Short Hills Road, Livingston, NJ 07039, USA.
Radiol Case Rep. 2021 Jun 12;16(8):2184-2186. doi: 10.1016/j.radcr.2021.05.035. eCollection 2021 Aug.
Granulomatosis with Polyangiitis (GPA) is a life threatening disease if left untreated which predominantly affects the adult population. As clinical presentation is often non-specific there is a heavy reliance on radiologic, laboratory and biopsy findings in diagnosis. We present a case of a 17-year-old male who presented with a history of tea colored urine and recurrent epistaxis who now complained of cough and congestion. The patient failed multiple courses of outpatient antibiotics and a CT of the chest while in the ED demonstrated multiple cavitary lesions. Subsequent workup and biopsy confirmed the diagnosis of GPA. It is important for the Radiologist and other clinicians to keep GPA in their differential when presented with a cavitary lung lesion as prompt treatment is required for good outcomes.
肉芽肿伴多血管炎(GPA)若不治疗会危及生命,主要影响成年人群。由于临床表现通常不具特异性,诊断严重依赖影像学、实验室及活检结果。我们报告一例17岁男性病例,该患者有茶色尿和反复鼻出血史,现主诉咳嗽和鼻塞。患者门诊多次使用抗生素治疗无效,急诊时胸部CT显示多个空洞性病变。后续检查及活检确诊为GPA。当出现肺部空洞性病变时,放射科医生和其他临床医生在鉴别诊断时考虑GPA很重要,因为及时治疗对取得良好疗效至关重要。