Shiotani A, Mukobayashi C, Oohata H, Yamanishi T, Hara T, Itoh H, Nishioka S
Second Department of Internal Medicine, Wakayama Medical College, Bancho.
Intern Med. 1997 Jul;36(7):514-8. doi: 10.2169/internalmedicine.36.514.
We treated a patient with an atypical presentation of Wegener's granulomatosis (WG) with dural involvement as the initial clinical manifestation. A 37-year-old man had a dural lesion without lower respiratory tract or renal manifestations in the initial clinical course. His only initial symptom was headache, and at disease onset computed tomography (CT) and magnetic resonance imaging (MRI) of the head revealed bilateral abnormal subdural masses. The diagnosis of WG was made based on the results of needle biopsy of the nasal polyps and the finding of positive circulating antineutrophil cytoplasmic antibodies (c-ANCA). He achieved remission on daily prednisone and cyclophosphamide with the later addition of sulfamethoxazole-trimethoprim.
我们治疗了一名以硬脑膜受累为初始临床表现的韦格纳肉芽肿（WG）非典型病例。一名37岁男性在疾病初期临床过程中出现硬脑膜病变，无下呼吸道或肾脏表现。他最初唯一的症状是头痛，疾病发作时头部计算机断层扫描（CT）和磁共振成像（MRI）显示双侧硬脑膜下异常肿块。根据鼻息肉针吸活检结果及循环抗中性粒细胞胞浆抗体（c-ANCA）阳性结果确诊为WG。他在每日服用泼尼松和环磷酰胺并随后加用磺胺甲恶唑-甲氧苄啶后病情缓解。
