Boubenider S A, Akhtar M, Alfurayh O, Algazlan S, Taibah K, Qunibi W
Department of Medicine, KFSH & RC, Riyadh, Saudi Arabia.
Clin Transplant. 1994 Feb;8(1):5-9.
An unusual case of a 46-year-old man who had end-stage renal disease due to crescentic glomerulonephritis that was treated by a cadaveric renal allograft is presented. About 18 months post-Tx, the patient developed severe tracheal stenosis which, on biopsy, revealed granulation tissue and chronic inflammation. After another 18 months he developed necrotizing glomerulonephritis involving the renal allograft and an inflammatory retro-orbital pseudotumor. The latter, on biopsy, revealed granulomatous vasculitis characteristic of Wegener's granulomatosis. This diagnosis was further confirmed by strongly positive anti-neutrophil antibodies with diffuse granular cytoplasmic immunofluorescence (C-ANCA). The patient was treated successfully with cyclophosphamide therapy.
本文报告了一例46岁男性的罕见病例，该患者因新月体性肾小球肾炎发展至终末期肾病，接受了尸体肾移植。肾移植术后约18个月，患者出现严重气管狭窄，活检显示为肉芽组织和慢性炎症。又过了18个月，他出现了累及移植肾的坏死性肾小球肾炎和眼眶后炎性假瘤。眼眶后炎性假瘤活检显示为韦格纳肉芽肿特征性的肉芽肿性血管炎。抗中性粒细胞抗体强阳性伴弥漫性颗粒状胞质免疫荧光（C-ANCA）进一步证实了这一诊断。患者接受环磷酰胺治疗后成功康复。
