Rhazari Meriem, Ramdani Hiba, Gartini Sara, Moueqqit Othman, Paidi Gokul, Musallam Mohammed, Thouil Afaf, Kouismi Hatim
Pulmonology, Mohammed VI University Hospital, Oujda, MAR.
Medicine, Mohammed VI University Hospital, Oujda, MAR.
Cureus. 2022 May 24;14(5):e25281. doi: 10.7759/cureus.25281. eCollection 2022 May.
Granulomatosis with polyangiitis (GPA) is a necrotizing granulomatous vasculitis of medium- and small-caliber vessels associated with the presence of antineutrophil cytoplasm antibodies (ANCAs) and antibodies specific for proteinase 3 (anti-PR3). The interest of this case lies on the fact that these antibodies are directed against myeloperoxidase revealed by the presence of scattered multiple pulmonary nodules. We report a 65-year-old-female patient who presented with a productive cough with mucus sputum associated with a cephalea for six months. The chest x-ray showed multiple pulmonary nodules, first suggesting a neoplastic origin. The initial etiological assessment was non-contributory. A month later, the patient developed pulmonary condensations and ocular signs. The etiological assessment then found ANCA anti-myeloperoxidase (anti-MPO)-GPA. A good knowledge of the clinical and radiological signs of GPA is important to quickly guide the diagnosis that will condition the prognosis of this disease.
肉芽肿性多血管炎（GPA）是一种累及中、小口径血管的坏死性肉芽肿性血管炎，与抗中性粒细胞胞浆抗体（ANCA）及抗蛋白酶3抗体（抗PR3）有关。该病例的有趣之处在于，这些抗体针对的是髓过氧化物酶，这可通过散在多发的肺结节得以揭示。我们报告一名65岁女性患者，她有咳痰伴黏液痰及头痛症状达6个月。胸部X线显示多发肺结节，最初提示肿瘤起源。初始病因评估未得出结论。1个月后，患者出现肺部实变及眼部体征。随后病因评估发现抗髓过氧化物酶（抗MPO）-GPA。充分了解GPA的临床和影像学表现对于快速指导诊断非常重要，而诊断将决定该疾病的预后。
