摘要
目的探讨抗中性粒细胞胞浆抗体(ANCA)相关性小血管炎(AASV)的临床特点及误诊原因,以减少误诊。方法回顾性分析1例误诊为肺炎的AASV的临床资料。结果此患者表现为间断性咳嗽、咳痰伴肾功能异常、双下肢水肿,按双侧肺炎反复抗感染治疗无效,且肾损害进行性加重,查P-ANCA(+),抗髓过氧化物酶(MPO)99.0 U/ml,确诊为AASV。经糖皮质激素、丙种球蛋白、血浆置换、血液透析及对症等治疗病情稳定。结论 AASV可累及多个器官和系统,临床上遇及反复肺部感染并抗感染治疗无效者,要考虑到本病,及时行ANCA抗体检测助诊。
Objective To explore the clinical characteristics and the cause of misdiagnosis in ANCA associated with small vessel vasculitis（AASV）,and to reduce misdiagnosis.Methods Retrospective analysis of clinical data of one patient with AASV misdiagnosed as having pneumonia was conducted.Results The clinical manifestations of the patient was of interrupted cough and cough-up phlegm with renal dysfunction and lower extremity edema.Treatment of repeated lung infections and clinical anti-inflammatory treatment failed,and progressive kidney damage occured.P-ANCA（＋）,antimyeloper oxidase antibody（MPO） 99.0 U/ml confirmed diagnosis AASV.After the treatment of Glucocorticoid,gammaglobulin plasma exchange,hematodialysis,the condition turned stable.Conclusion AASV can damage multiple organs and systems.In patients with repeated lung infections and failed clinical anti-inflammatory treatment,possibility of this disease should be taken into account.Laboratory examination of anti-neutrophil cytoplasm antibodies is useful in diagnosis.
出处
《临床误诊误治》
2011年第11期51-53,共3页
Clinical Misdiagnosis & Mistherapy
关键词
血管炎
抗体
抗中性白细胞胞质
误诊
肺炎
Vasculitis
Antibody
antineutrophil cytoplasmic
Diagnostic error
Pneumonia
