以中耳乳突炎为首发症状的韦格纳肉芽肿

Otomastoiditis as the Firts Symptom of Wagener's Granulomatosis

刁明芳;孙建军;洪柳;林井副;郭红光;余永武;童艳;

1:海军总医院全军耳鼻咽喉科中心

2:海军总医院病理科

3:海军总医院医学影像中心

4:海军总医院肾内科

摘要
目的探讨韦格纳肉芽肿(Wegener's granulomatosis,WG)的耳部表现、被忽视的原因及避免延误治疗的措施,提高耳科医生对本病的认识。方法回顾性分析1例以耳科临床表现为首发症状的韦格纳肉芽肿患者的临床资料和诊治过程。结果根据患者耳科症状诊断为"中耳乳突炎",行左侧乳突切开、鼓室探查、鼓室成形术,术后听力无改善,1月后出现肾脏受损的临床表现,肾脏穿刺活检及抗中性粒细胞胞浆抗体检测确诊为WG,经环磷酰胺与泼尼松龙冲击治疗,病情控制,听力改善。结论当WG以耳科局部症状首发,常规治疗中耳炎无效并出现其他系统症状时,要高度怀疑WG。需与相关科室协作,对患者进行全面检查,避免误诊与误治。
关键词
韦格纳肉芽肿;中耳乳突炎;肾脏穿刺;抗中性粒细胞胞浆抗体
基金项目(Foundation):
首都发展基金资助项目(2005-2037)
作者
刁明芳;孙建军;洪柳;林井副;郭红光;余永武;童艳;
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