Caralis P V, Falanga V, Pardo V
South Med J. 1981 Jul;74(7):882-3. doi: 10.1097/00007611-198107000-00029.
We have described a patient in whom renal manifestations preceded the pulmonary findings of Wegener's granulomatosis by two years. He presented with rapidly progressive glomerulonephritis requiring chronic hemodialysis despite treatment with prednisone and azathioprine. Wegener's granulomatosis was diagnosed only after other signs of the generalized form of the disease had become manifest. Review of the literature revealed four similar cases. In patients with similar clinical presentations, serious consideration should be given to this delayed form of the syndrome. A course of cytotoxic therapy should be tried while the patient is followed up for further manifestations of generalized Wegener's granulomatosis.
我们描述了一位患者，其肾脏表现比韦格纳肉芽肿的肺部表现提前两年出现。他表现为快速进展性肾小球肾炎，尽管接受了泼尼松和硫唑嘌呤治疗，仍需要进行慢性血液透析。直到该疾病全身表现的其他体征出现后，才诊断出韦格纳肉芽肿。文献回顾发现了4例类似病例。对于临床表现相似的患者，应认真考虑这种综合征的延迟形式。在对患者进行随访以观察韦格纳肉芽肿全身进一步表现的同时，应尝试进行一个疗程的细胞毒性治疗。
