Sokol R J, Farrell M K, McAdams A J
Gastroenterology. 1984 Aug;87(2):426-32.
An unusual presentation of Wegener's granulomatosis is described in a 16.67-yr-old black woman with diarrhea, fever, weight loss, abdominal pain, arthralgias, and mouth ulcers, suggesting the diagnosis of inflammatory bowel disease. However, biopsy specimens of rectal mucosa, oro- and nasopharynx, and skin conclusively demonstrated the vasculitic lesion of Wegener's granulomatosis. Furthermore, cyclophosphamide therapy induced remission of clinical and histologic abnormalities. This case emphasizes the diagnostic value of taking biopsy specimens of oral lesions in patients with suspected inflammatory bowel disease and demonstrates that the presentation of Wegener's granulomatosis may mimic that of inflammatory bowel disease.
一名16.67岁的黑人女性出现了不寻常的韦格纳肉芽肿表现,伴有腹泻、发热、体重减轻、腹痛、关节痛和口腔溃疡,提示诊断为炎症性肠病。然而,直肠黏膜、口腔和鼻咽部以及皮肤的活检标本最终证实了韦格纳肉芽肿的血管病变。此外,环磷酰胺治疗使临床和组织学异常得到缓解。该病例强调了对疑似炎症性肠病患者进行口腔病变活检标本的诊断价值,并表明韦格纳肉芽肿的表现可能类似于炎症性肠病。