Navarro J F, Quereda C, Rivera M, Navarro F J, Ortuño J
Department of Nephrology, Hospital Ramón y Cajal, Madrid, Spain.
Postgrad Med J. 1994 May;70(823):373-5. doi: 10.1136/pgmj.70.823.373.
A 68 year old man presented with a systemic necrotizing vasculitis and elevated levels of anti-neutrophil cytoplasmic antibody (ANCA) which responded to treatment with steroids and cyclophosphamide, with a decrease in the titre of ANCA until its disappearance. Four months later he presented with weakness, loss of weight, aphonia and dysphagia. A computerized tomography scan showed a solid mass in the anterior mediastinum, and histological studies revealed an undifferentiated adenocarcinoma. Vasculitis improved although the malignancy progressed and ANCA was persistently negative. Our case demonstrates an association between ANCA and paraneoplastic vasculitis.
一名68岁男性患者，出现系统性坏死性血管炎，抗中性粒细胞胞浆抗体（ANCA）水平升高，经类固醇和环磷酰胺治疗后病情缓解，ANCA滴度下降直至消失。四个月后，他出现乏力、体重减轻、失音和吞咽困难。计算机断层扫描显示前纵隔有一实性肿块，组织学检查显示为未分化腺癌。尽管恶性肿瘤进展，但血管炎有所改善，且ANCA持续呈阴性。我们的病例显示了ANCA与副肿瘤性血管炎之间的关联。
