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Wegener's Granulomatosis: Case Report

机译：韦格纳肉芽肿病：病例报告

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Wegener's granulomatosis is an inflammatory disease with multi-system involvement that manifests as vasculitis, granulomatosis and necrosis. While its standard form involves the upper and lower respiratory tracts and kidneys, it may essentially involve any organ. In approximately 80-90% of the patients, the nose and the paranasal sinuses are involved. Neurological complications may accompany the disease in 50% of the cases.Our 65 year-old male patient was investigated at the clinic due to the occurrence of neurological symptoms while he was on treatment for upper respiratory tract and lung lesion. In this report, we wanted to emphasize that Wegener's granulomatosis, although rare, should be considered even if the ANCA values were negative and that treatment should be initiated as soon as possible. Introduction Wegener's Granulomatosis (WG) is a disease of unknown etiology, which has been described for the first time by Wegener in 1936 (1). The prevalence of this rare disease is estimated to be 3/100000 in the United States (2). WG is characterized by a triad of granulomatous lesions of the upper and lower respiratory tract, focal segmental glomerulonephritis and disseminated necrotizing vasculitis. While involvement of the upper respiratory tract and the lungs is observed in its limited form frequently seen in women, the kidneys are also involved in the common form frequently seen in men (3). Direct invasion of the paranasal and paraaural tissues by the granulomatous process, metastasis of the granulomatous process and necrotizing vasculitis cause neurological symptoms. Neurological involvement occurs in one third of the patients. It commonly manifests as peripheral neuropathy or cranial neuropathy (particularly 2,6,7). ANCA is considered to be responsible for the pathogenesis together with the intervening infections. The mortality rate is high among untreated WG cases. Case Report A 65 year-old male patient presented with the complaints of pain in the left eye, hyperemia in the conjunctiva, nasal lesion and diplopia on left gaze. His medical history included the complaints of sweating, lack of appetite and debility with an onset in August 2004. Thoracic computed tomography (CT) revealed a cavitary lesion of 1.5 x 2 cm size at the left lung lower lobe superior segment (Figure 1).
机译：韦格纳肉芽肿病是一种炎症性疾病，涉及多系统，表现为血管炎，肉芽肿和坏死。虽然其标准形式涉及上，下呼吸道和肾脏，但实际上可能涉及任何器官。在大约80-90％的患者中，鼻子和鼻旁窦受累。该病有50％的病例伴有神经系统并发症。我们这名65岁的男性患者在接受上呼吸道和肺部病变治疗时由于出现神经系统症状而在诊所接受了调查。在本报告中，我们要强调的是，即使ANCA值为阴性，也应考虑Wegener肉芽肿病，尽管这种情况很少见，并且应尽快开始治疗。简介韦格纳肉芽肿病（WG）是一种病因不明的疾病，韦格纳在1936年首次对其进行了描述（1）。在美国，这种罕见病的患病率估计为3/100000（2）。 WG的特征是上呼吸道和下呼吸道肉芽肿性病变，局灶性节段性肾小球性肾炎和弥散性坏死性血管炎三联征。上呼吸道和肺部受累的形式在女性中很常见，而肾脏也以男性中常见的常见形式受累（3）。肉芽肿过程直接侵入鼻旁和耳旁组织，肉芽肿过程的转移和坏死性血管炎引起神经系统症状。三分之一的患者发生神经系统受累。它通常表现为周围神经病或颅神经病（尤其是2,6,7）。 ANCA被认为是引起发病以及中间感染的原因。在未经治疗的WG病例中，死亡率很高。病例报告一名65岁的男性患者，主诉左眼疼痛，结膜充血，鼻部病变和左眼复视。他的病史包括在2004年8月开始出汗，食欲不振和身体虚弱的主诉。胸腔计算机断层扫描（CT）显示左肺下叶上段有1.5 x 2 cm大小的空洞病变（图1）。

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