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首页> 外文期刊>Auris, nasus, larynx >Difficulty of diagnosing Wegener's granulomatosis in the head and neck region.
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Difficulty of diagnosing Wegener's granulomatosis in the head and neck region.

机译：诊断韦格纳肉芽肿在头部和颈部的困难。

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OBJECTIVE: The objective of this study was to review the various clinical features associated with Wegener's granulomatosis (WG) in the head and neck region and to discuss the difficulty of diagnosing patients with early stage WG. METHODS: Between January 1998 and August 2007, WG was diagnosed and treated in 16 patients at the Department of Otolaryngology, Hyogo College of Medicine. Clinical and operating records of these patients were analyzed retrospectively. Diagnosis was based on the Japanese criteria proposed by the Japanese Ministry of Health and Welfare in 1998. RESULTS: Ten patients (62.5%) had a definite diagnosis of WG, and the other six patients (37.5%) had a probable diagnosis of WG. The period from the onset to diagnosis was between 1 month and 30 years. The generalized form of WG was observed in three patients (18.8%), and the limited form of WG was observed in the other 13 patients (81.2%). Nasal, aural, and ophthalmic symptoms were initially presented in 10, 3, and 3 patients, respectively. Cytoplasmic pattern antineutrophil cytoplasmic antibodies (cANCAs) and perinuclear pattern ANCA (pANCA) were positively detected in 68.8% (11/16) and 27.2% (3/11) of the patients, respectively. Five of 14 patients (35.7%) had pathologic features of WG in biopsy samples from the head and neck region. Three patients in whom a diagnosis of WG was difficult are presented, and immediate lessons of our experience were discussed. CONCLUSIONS: This study emphasized the difficulty of diagnosing WG, particularly at an early stage and when limited to the head and neck region. The biggest challenge faced in diagnosing WG is that it requires a high index of suspicion. When WG was suspected, we should obtain an accurate medical history from patients and repeat serologic and histopathologic examinations.
机译：目的：本研究的目的是回顾与头颈部颈部韦格纳肉芽肿病（WG）相关的各种临床特征，并讨论诊断早期WG的患者的困难。方法：1998年1月至2007年8月，在兵库大学医学院耳鼻咽喉科诊断并治疗了16名患者。回顾性分析这些患者的临床和手术记录。诊断基于1998年日本厚生省提出的日本标准。结果：10例患者（62.5％）明确诊断为WG，其他6例患者（37.5％）明确诊断为WG。从发病到诊断的时间为1个月至30年。 WG的广义形式在3例患者中观察到（18.8％），WG的有限形式在其他13例患者中观察到（81.2％）。最初分别在10、3和3位患者中出现鼻，耳和眼科症状。分别在68.8％（11/16）和27.2％（3/11）的患者中阳性检测到细胞质模式抗中性粒细胞胞浆抗体（cANCAs）和核周模式ANCA（pANCA）。 14例患者中有5例（35.7％）在头颈部区域的活检样本中具有WG的病理特征。介绍了三名难以诊断WG的患者，并讨论了我们的经验教训。结论：本研究强调了WG的诊断困难，尤其是在早期阶段以及仅限于头颈部区域时。诊断WG面临的最大挑战是，它需要高度怀疑。如果怀疑有WG，我们应该从患者那里获得准确的病史，并重复进行血清学和组织病理学检查。

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