一例嗜酸性粒细胞肉芽肿伴多血管炎伴弥漫性肺泡出血的病例:病例报告和病例回顾。

IF 0.9 Q4 RHEUMATOLOGY Modern rheumatology case reports Pub Date : 2024-07-08 DOI:10.1093/mrcr/rxae019
Rira Kawaguchi, Hirohisa Usagawa, Yoshia Miyawaki, Hiroshi Oiwa
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引用次数: 0

摘要

一名 76 岁的支气管哮喘患者因呼吸衰竭和痰中带血而入院。临床诊断为弥漫性肺泡出血(AH)。髓过氧化物酶-抗中性粒细胞胞浆抗体(MPO-ANCA)呈阳性,尿检提示肾小球肾炎。根据嗜酸性粒细胞增多症、鼻窦炎、周围神经受累和白细胞凝集性血管炎,他被诊断为嗜酸性粒细胞肉芽肿伴多血管炎(EGPA)伴 AH。我们基于病例的研究表明,EGPA 患者中男性占多数(65%)、ANCA 阳性率高(88%)和肾脏受累频率高(45%)可能是 AH 的特征。虽然 AH 在 EGPA 中较为罕见,但我们仍应警惕这种危及生命的并发症。
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A case of eosinophilic granulomatosis with polyangiitis associated with diffuse alveolar haemorrhage: A case report and case-based review.

A 76-year-old man with bronchial asthma was admitted for respiratory failure and bloody sputum. A significant drop in haemoglobin and multiple consolidations supported clinical diagnosis of diffuse alveolar haemorrhage (AH). Myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) was positive and urinalysis suggested glomerulonephritis. Based on eosinophilia, sinusitis, peripheral nerve involvement, and leukocytoclastic vasculitis, he was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA) associated with AH. Our case-based review suggested that male predominance (65%), high positivity for ANCA (88%), and a high frequency of renal involvement (45%) may be characteristic of AH in EGPA. Although AH is rare in EGPA, we should be aware of this life-threatening complication.

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