ANCA-阴性粒状瘤与多炎模仿鼻炎和鼻瘤:一个病例报告
Sergey Gorbunov1,2, Georgiy Polev1
1Department of Head and Neck Surgery, Ilyinskaya Hospital, Moscow Oblast, Russia.
Case reports in medicine
|March 2, 2026
概括
带有多管炎 (GPA) 的ANCA阴性粒状炎可以模仿慢性鼻炎. 负的ANCA测试并不排除GPA,强调在破坏性鼻病例中需要临床怀疑.
科学领域:
- 类风湿病学 类风湿病学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 病理学 病理学 病理学
背景情况:
- 带有多叶膜炎 (GPA) 的粒状瘤炎是一种罕见的自身免疫性血管炎.
- 典型的GPA呈现出积极的抗中性粒细胞体抗体 (ANCA) 血清学.
- 诊断延迟可能导致严重的器官损伤.
研究的目的:
- 描述一个具有挑战性的ANCA阴性GPA病例.
- 为了突出耐火性鼻腔疾病的诊断陷.
- 强调在非典型呈现中临床怀疑的重要性.
主要方法:
- 一个65岁的女性患有耐火性慢性鼻炎的病例报告.
- 详细的临床过程,包括破坏性的鼻和全身表现.
- 对诊断工作的审查,包括连续的微生物学,组织学和ANCA测试.
- 用Rituximab和皮质类固醇治疗.
主要成果:
- 患者出现了模仿复发性感染和其他颗粒状疾病的症状.
- 尽管进行了多次干预,但她出现了严重的破坏性表现,包括鼻腔隔膜穿孔,鼻,角膜炎和神经缺陷.
- 在整个诊断过程中,ANCA血清学仍然呈阴性.
- 用Rituximab和皮质类固醇治疗导致显著的临床改善和缓解.
结论:
- 阴性ANCA的GPA可以潜伏地呈现耐火性鼻腔疾病.
- 没有ANCA并不排除GPA的诊断.
- 高临床怀疑对于及时诊断和启动免疫抑制疗法至关重要,以防止不可逆转的器官损伤.
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