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肉芽肿性多血管炎合并肠系膜上动脉夹层动脉瘤1例罕见病例

A Rare Case of Dissecting Superior Mesenteric Artery Aneurysm in Granulomatosis with Polyangiitis.

作者信息

Tanaka Shinichi, Ohmine Takahiro, Maeda Takashi

机构信息

Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Hiroshima, Japan.

出版信息

Ann Vasc Dis. 2023;16(4):269-272. doi: 10.3400/avd.avd.cr.23-00050. Epub 2023 Oct 13.

DOI:10.3400/avd.avd.cr.23-00050
PMID:38188973
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10766743/
Abstract

An asymptomatic dissecting superior mesenteric artery (SMA) aneurysm in granulomatosis with polyangiitis (GPA), historically termed Wegener's granulomatosis, is rare. We herein describe a 68-year-old man who was diagnosed with GPA based on a high level of proteinase 3 (PR3)-antineutrophil cytoplasmic antibody (ANCA). One year after remission of GPA, the patient developed pyelonephritis, and his PR3-ANCA level increased again. Computed tomography showed a rapid increase in the size of the dissecting SMA aneurysm. The patient underwent successful endovascular stent-graft repair. At the time of this writing, 3 years had passed since the surgery and the clinical course was good.

摘要

在肉芽肿性多血管炎（GPA，既往称为韦格纳肉芽肿）中，无症状的肠系膜上动脉（SMA）夹层动脉瘤较为罕见。我们在此描述一名68岁男性，其基于高水平的蛋白酶3（PR3）-抗中性粒细胞胞浆抗体（ANCA）被诊断为GPA。GPA缓解一年后，患者发生肾盂肾炎，其PR3-ANCA水平再次升高。计算机断层扫描显示夹层SMA动脉瘤大小迅速增加。患者接受了成功的血管内支架植入修复术。在撰写本文时，手术已过去3年，临床过程良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b88/10766743/91b1aee85e46/avd-16-269-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b88/10766743/4cbd757fee95/avd-16-269-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b88/10766743/414b9057d637/avd-16-269-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b88/10766743/91b1aee85e46/avd-16-269-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b88/10766743/4cbd757fee95/avd-16-269-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b88/10766743/414b9057d637/avd-16-269-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b88/10766743/91b1aee85e46/avd-16-269-g003.jpg

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本文引用的文献

1
Ruptured arterial aneurysm in Wegener's granulomatosis: a case report.韦格纳肉芽肿病致破裂性动脉动脉瘤：病例报告。
J Med Case Rep. 2021 Jul 12;15(1):343. doi: 10.1186/s13256-021-02955-7.
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The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms.血管外科学会内脏动脉瘤治疗临床实践指南。
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Therapeutic management of superior mesenteric artery aneurysms.肠系膜上动脉动脉瘤的治疗管理。
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Arterial aneurysms in Wegener's granulomatosis: case report and literature review.韦格纳肉芽肿病中的动脉动脉瘤：病例报告及文献综述
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5
Uncommon splanchnic artery aneurysms: pancreaticoduodenal, gastroduodenal, superior mesenteric, inferior mesenteric, and colic.罕见的内脏动脉动脉瘤：胰十二指肠动脉、胃十二指肠动脉、肠系膜上动脉、肠系膜下动脉和结肠动脉。
Ann Vasc Surg. 1996 Sep;10(5):506-15. doi: 10.1007/BF02000601.