Parreira M, Custódio P, Sá J, Mendes J, Mendes A P, Poças J
Serviço de Medicina II, Hospital Distrital de Setúbal.
Acta Med Port. 1994 Jun;7(6):353-7.
The authors present a case report of a 62-year old woman, with hypertension for many years. She suffered from weakness, anorexia and weight loss in the last 6 months. On admission, anemia, elevated ESR, haematuria, proteinuria and renal failure were present. Renal biopsy was compatible with chronic glomerulonephritis. The clinical picture and positivity for P-ANCA suggested systemic vasculitis. Later evidence of maxillary sinusitis and nasal mucosae ulcers as well as pneumonitis, although biopsy did not reveal granulomas, suggested the diagnosis of Wegener Vasculitis. Medicated with Cyclophosphamide and Prednisolone, for a year, with improvement. The authors make a brief discussion of the clinical criteria for classification of ANCA-associated systemic vasculitis.
作者报告了一例62岁患有多年高血压的女性病例。在过去6个月里，她出现了乏力、厌食和体重减轻的症状。入院时，发现有贫血、血沉升高、血尿、蛋白尿和肾衰竭。肾活检结果符合慢性肾小球肾炎。临床表现及P-ANCA阳性提示系统性血管炎。后来出现的上颌窦炎、鼻黏膜溃疡以及肺炎的证据，尽管活检未发现肉芽肿，但提示诊断为韦格纳肉芽肿。给予环磷酰胺和泼尼松龙治疗一年后病情好转。作者简要讨论了ANCA相关系统性血管炎的分类临床标准。
