Tojo J, Nishimaki T, Ohyanagi H, Saito A, Ohira H, Saka M, Kuroda M, Ishikawa H, Kasukawa R
Department of Internal Medicine II, Fukushima Medical University, School of Medicine, Fukushima.
Intern Med. 1998 Aug;37(8):711-5. doi: 10.2169/internalmedicine.37.711.
A 61-year-old woman presented with high fever, headache and left facial palsy with diplopia. Histopathological examination of the biopsied specimens taken from nasal mucosa and kidney revealed a granulomatous angiitis with giant cell infiltration. Ga-DTPA-enhanced magnetic resonance imaging (MRI) revealed a thickening of dura mater in the middle cranial fossa and tentorium cerebelli. The observed left facial and occulomotor palsy was considered to be caused by pachymeningitis associated with Wegener's granulomatosis (WG). Cyclophosphamide combined with prednisolone effectively improved the symptoms. However, the patient died of acute interstitial pneumonitis, presumably caused by cyclophosphamide. The pathohistology obtained in the autopsy revealed a fibrous thickening of the dura mater in the left meningen with a segmental scarring of the arteries and a necrotizing arteritis in the kidney.
一名61岁女性出现高热、头痛及左侧面瘫伴复视。对取自鼻黏膜和肾脏的活检标本进行组织病理学检查，发现为伴有巨细胞浸润的肉芽肿性血管炎。钆喷酸葡胺增强磁共振成像（MRI）显示中颅窝和小脑幕硬脑膜增厚。观察到的左侧面部及动眼神经麻痹被认为是由韦格纳肉芽肿病（WG）相关的硬脑膜炎所致。环磷酰胺联合泼尼松龙有效改善了症状。然而，患者死于可能由环磷酰胺引起的急性间质性肺炎。尸检获得的病理组织学显示左侧脑膜硬脑膜纤维性增厚，伴有动脉节段性瘢痕形成及肾脏坏死性动脉炎。
