Gormley Amanda, Green Peter
Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Division of Clinical Dermatology and Cutaneous Science, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
SAGE Open Med Case Rep. 2024 Dec 11;12:2050313X241304229. doi: 10.1177/2050313X241304229. eCollection 2024.
Granulomatosis with polyangiitis, a type of small-medium vessel vasculitis, can pose diagnostic challenges due to its diverse clinical manifestations. We present a case that mimicked multisystem pyoderma gangrenosum with cutaneous ulceration, renal sparing, and antineutrophil cytoplasmic antibody negativity. Although antineutrophil cytoplasmic antibody is positive in approximately 90% of cases of granulomatosis with polyangiitis, its negativity should not exclude the diagnosis. Additionally, pyoderma gangrenosum-like cutaneous ulcers should prompt consideration of granulomatosis with polyangiitis, especially in the context of multisystem disease presentation. This case underscores the importance of maintaining a high suspicion for granulomatosis with polyangiitis in patients presenting with cutaneous ulceration and respiratory tract disease.
肉芽肿性多血管炎是一种中小血管血管炎，因其临床表现多样，可带来诊断挑战。我们报告一例病例，该病例表现为类似多系统坏疽性脓皮病，有皮肤溃疡、肾脏未受累及抗中性粒细胞胞浆抗体阴性。虽然在大约90%的肉芽肿性多血管炎病例中抗中性粒细胞胞浆抗体呈阳性，但其阴性并不能排除诊断。此外，坏疽性脓皮病样皮肤溃疡应促使考虑肉芽肿性多血管炎，特别是在多系统疾病表现的情况下。该病例强调了对出现皮肤溃疡和呼吸道疾病的患者高度怀疑肉芽肿性多血管炎的重要性。
