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。
Objective The study was aimed to explore the otology manifestations of Wegener’s granulomatosis（WG）,the overlooked causes and measures to avoid delay in treatment,in order to raise the awareness of the disease among otologist community.Methods The clinical information and treatment process of one case of was which otology manifestations was the first symtors,was analysed.Results Otomastoiditis was diagnosed according to the otology manifestations,followed by mastoid surgery without hearing improvement.Several days later,the clinical manifestations of kindey damage occurred.The diagnosis of WG was made by renal biospy and the testing of anticytoplasmic antibodies versus neutrophilpolymorphonucleate granules（c-ANCA）.The combined treatment of cyclophosphamide and prednisolone was contributed to the disease controlled and hearing improvement.Conclusion A high level of suspicion of this disease is needed,especially whas WG presents as a local manifestation and a prolonged classic therapy for otitis is ineffective.It is important to cooperate with other related departments and overall tests,in order to avoid wrong diagnosis and treatment.
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2011年第3期203-206,共4页
Journal of Audiology and Speech Pathology
基金
首都发展基金资助项目(2005-2037)
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
Wegener＇s granulomatosis
Otomastoidibis
Renal biospy
Anticytoplasmic antibodies ver-sus neutrophil polymorphonueleate granules
