Wegener氏肉芽腫－病例報告

Wegener's Granulomatosis - Case Report

林肇穗(Chao-Sui Lin) ； 蘇茂昌(Mao-Chang Su) ； 李清課(Ching-Keh Lee) ； 陳宗琨(Tseng-Kun Chen) ； 郭恆甫(Hen-Fu Kuo) ； 張昭明(Chau-Ming Chang)

《中華民國耳鼻喉科醫學會雜誌》 32卷4期 (1997/08) Pp. 439-443

https://doi.org/10.6286/1997.32.4.439

摘要

Wegner氏肉芽腫(Wegner’s granulomatosis)之典型發炎病灶包括壞死，血管炎及肉芽腫之形成，與其他壞死性血管炎的差別在於它易侵犯上下呼吸道及腎臟。病程進展程度差異很大，隱襲性到快速進展致死皆有。目前的報告以免疫抑制劑cyclophosphamide加上類固醇的治療結果較好。本科在1988年經驗一例成人局限型Wegener氏肉芽腫，以上述之化學治療8年多，臨床症狀無復發現象，紅血球沈降速率(ESR)亦控制在正常範圍之內。今將其臨床表徵、病理學及近年來治療趨勢提出討論。(中耳醫誌 1997;32:439-443)

關鍵字

魏氏肉芽腫 ； 血管炎 ； 肉芽腫性變化

並列摘要

Wegener’s granulomatosis is distinguished from other necrotizing vasculitis by it’s predilection of affect the upper, lower respiratory tracts and kidney. In most cases, the inflammatory lesions typically include necrosis, granulomatous change and vasculitis.
In 1988, we experienced a case of limited form of Wegener’s granulomatosis without involving the kidney. A 25-year-old man complained of recurrent right epistaxis for 6 weeks, bilateral hearing impairment and right otorrhea for 3 weeks. Physical examinations revealed ulcerative lesions on the right middle and inferior turbinates and right purulent otorrhea. Sinus computed tomogrtaphic scan showed haziness on bilateral ethmoid and right maxillary sinuses. After the specimens being obtained through the right CaldwellLuc’s operation, the histopathologic report was necrotizing granulomatous inflammation and vasculitis.
After being treated with cyclophosphamide and prednisolone, there has been no evidence of relapse till now.

並列關鍵字

Wegener's granulomatosis ； vasculitis ； granulomatous change