一例嗜酸性粒细胞肉芽肿伴多血管炎合并肺结核的病例:病例报告。

IF 1.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Medicine Pub Date : 2024-09-13 DOI:10.1097/md.0000000000039721
Yuting Lai,Shan Xiao,Yan Shen
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引用次数: 0

摘要

理由嗜酸性粒细胞肉芽肿伴多血管炎(EGPA)是一种罕见的自身免疫性疾病,可影响多个器官系统。标准治疗主要依靠糖皮质激素和免疫抑制剂。五因素评分显示,患者需要糖皮质激素联合免疫抑制剂进行诱导治疗,但使用免疫抑制剂会明显抑制抗结核治疗。目前,治疗感染患者的活动性自身免疫性疾病仍是一项临床挑战。干预考虑到患者没有出现危及生命或严重的器官受累,并且降低了抗结核免疫的效果,我们单独使用了糖皮质激素。结果最终,患者没有出现任何不良反应,嗜酸性粒细胞计数明显降低,EGPA症状得到缓解。
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A case of eosinophilic granulomatosis with polyangiitis combined with pulmonary tuberculosis: A case report.
RATIONALE Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare autoimmune disease that can affect multiple organ systems. The standard treatment mainly relies on glucocorticoids and immunosuppressive agents. In our study, we present an EGPA patient who had pulmonary tuberculous mycobacteria infection, such cases are rarely reported. PATIENT CONCERNS A 71-year-old male patient was diagnosed with EGPA (systemic type) and pulmonary tuberculosis simultaneously. DIAGNOSES The Five-Factor score indicated that the patient required glucocorticoids combined with immunosuppressive agents for induction therapy, however, the use of immunosuppressive agents would significantly inhibit antituberculosis treatment. Nowadays, treating active autoimmune disease in patients with infections remains a clinical challenge. INTERVENTIONS Considering the patient did not show life-threatening or severe organ involvement and reduced the effect of antituberculosis immunity, we used glucocorticoids alone. OUTCOMES Finally, the patient had no adverse events, the eosinophil counts were markedly decreased and symptoms of EGPA were relieved. LESSONS The patient of EGPA combined with pulmonary tuberculosis successfully treated with glucocorticoids alone may provide significant support in selecting the appropriate treatments for similar cases in the future.
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来源期刊
Medicine
Medicine 医学-医学:内科
CiteScore
2.80
自引率
0.00%
发文量
4342
审稿时长
>12 weeks
期刊介绍: Medicine is now a fully open access journal, providing authors with a distinctive new service offering continuous publication of original research across a broad spectrum of medical scientific disciplines and sub-specialties. As an open access title, Medicine will continue to provide authors with an established, trusted platform for the publication of their work. To ensure the ongoing quality of Medicine’s content, the peer-review process will only accept content that is scientifically, technically and ethically sound, and in compliance with standard reporting guidelines.
期刊最新文献
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