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Medicus
2004, vol. 5, br. 1, str. 46-49
jezik rada: srpski
vrsta rada: prikaz slučaja
objavljeno: 02/06/2007
Wegenerova granulomatoza kao uzrok febrilnog stanja nejasne etiologije
Klinički centar Kragujevac, Klinika za infektivne bolesti

Sažetak

Wegenerova granulomatoza je bolest nepoznate etiologije sa nekrotizirajućim granulomatoznim vaskulitisom uglavnom u gornjim i donjim disajnim putevima kao i u bubrezima. U radu je prikazana bolesnica, stara 33 godine, koja je lečena u Infektivnoj klinici KBC-a u Kragujevcu. Na osnovu klračke slike produženog febrilnog stanja, patoloških plućnih promena i nalaza antitela na citoplazmu neutrofila u serumu bolesnice, postavljena je sumnja na Wegenerovu granulomatozu. Histopatološkim pregledom bioptiranih granulacionih promena u epifarinksu i septumu nosa ova dijagnoza je potvrdjena. Na primenjenu terapiju ciklofosfamidom u pulsnim dozama i kontinuiranim dozama glikokortikoida u bolesnice je postignuta remisija. Iako je Wegenerova granulomatoza klinički raritet, u bolesnika sa febrilnim stanjem nejasne etiologije, naročito ako postoje patološke promene na plućima u, diferencijalnoj dijagnozi treba uzeti u obzir i ovu bolest.

Ključne reči

Wegenerova granulomatoza; febrilno stanje nejasne etiologije

Reference

de Groot, K., Gross, W.L. (1998) Wegener's granulomatosis: Disease course, assessment of activity and extent and treatment. Lupus, 7(4): 285-91
Devaney, K.O., Travis, W.D., Hoffman, G., Leavitt, R., Lebovics, R., Fauci, A.S. (1990) Interpretation of head and neck biopsies in Wegener's granulomatosis. A pathologic study of 126 biopsies in 70 patients. Am J Surg Pathol, 14(6): 555-64
Duna, G.F., Galperin, C., Hoffman, G.S. (1995) Wegener's granulomatosis. Rheum Dis Clin North Am, 21(4): 949-86
Habib, A., MacKay, K., Abrons, H.L. (1996) Wegener's granulomatosis complicating pregnancy: Presentation of two patients and review of the literature. Clin Nephrol, 46(5): 332-6
Haubitz, M., Koch, K.M., Brunkhorst, R. (1998) Survival and vasculitis activity in patients with end-stage renal disease due to Wegener's granulomatosis. Nephrol Dial Transplant, 13(7): 1713-8
Hoffman, G.S., Specks, U. (1998) Antineutrophil cytoplasmic antibodies. Arthritis Rheum, 41(9): 1521-37
Hunder, G.G. (1995) Vasculitis. Rheum Dis Clin North Am, 21, str. 861-1134
Kallenberg, C.G., Brouwer, E., Weening, J.J., Tervaert, J.W. (1994) Anti-neutrophil cytoplasmic antibodies: Current diagnostic and pathophysiological potential. Kidney Int, 46(1): 1-15
Kuchel, J., Lee, S. (2003) Cutaneous Wegener's granulomatosis: A variant or atypical localized form?. Australas J Dermatol, 44(2): 129-35
Langford, C.A., Talar-Williams, C., Barron, K.S., Sneller, M.C. (1999) A staged approach to the treatment of Wegener's granulomatosis: Induction of remission with glucocorticoids and daily cyclophosphamide switching to methotrexate for remission maintenance. Arthritis Rheum, 42(12): 2666-73
Langford, C.A., Talar-Williams, C., Barron, K.S., Sneller, M.C. (2003) Use of a cyclophosphamide-induction methotrexate-maintenance regimen for the treatment of Wegener's granulomatosis: Extended follow-up and rate of relapse. Am J Med, 114(6): 463-9
Lim, K.S., Lee, G.A., Pavesio, C.E., Ficker, L.A. (2003) Wegener's granulomatosis. Br J Ophthalmol, 87: 500
Lockwood, C.M., Thiru, S., Isaacs, J.D., Hale, G., Waldmann, H. (1993) Long-term remission of intractable systemic vasculitis with monoclonal antibody therapy. Lancet, 341(8861): 1620-2
Ludviksson, B.R., Sneuer, M.C., Chua, K.S., i dr. (1988) Active Weeener's granulomatosis is associated with HLA-DR+ CD4+ T cells exhibiting an unbalanced Thl-type T cell cytokine pattern: Reversal with IL-10. J Immunol, 167, str. 3602-609
Mirčetić, V., Petrović, M., Savić, R. (1998) Karakteristike i značaj antitela specifičnih za citoplazmu neutrofilnih leukocita čoveka. Acta rheumatologica Belgradensia, 28, str. 42-51
Nolle, B., Specks, U., Ludemann, J., Rohrbach, M.S., DeRemee, R.A., Gross, W.L. (1989) Anticytoplasmic autoantibodies: Their immunodiagnostic value in Wegener granulomatosis. Ann Intern Med, 111(1): 28-40
Pavlović, M. (2001) Febrilna stanja nejasnog porekla. u: Delić D. [ur.] Infektivne bolesti - laboratorijska dijagnostika i lečenje, Beograd: Zavod za udžbenike i nastavna sredstva, 309-14
Petrović, R. (2000) Sistemski vaskulitisi. u: Pilipović N. [ur.] Reumatologija, Beograd: Zavod za udžbenike i nastavna sredstva, str. 439-65
Rao, J.K., Allen, N.B., Feussner, J.R., Weinberger, M. (1995) A prospective study of antineutrophil cytoplasmic antibody (c-ANCA) and clinical criteria in diagnosing Wegener's granulomatosis. Lancet, 346(8980): 926-31
Savige, J., Davies, D., Falk, R.J., Jennette, J.C., Wiik, A. (2000) Antineutrophil cytoplasmic antibodies and associated diseases: A review of the clinical and laboratory features. Kidney Int, 57(3): 846-62
Sneller, M.C., Hoffman, G.S., Talar-Williams, C., Kerr, G.S., Hallahan, C.W., Fauci, A.S. (1995) An analysis of forty-two Wegener's granulomatosis patients treated with methotrexate and prednisone. Arthritis Rheum, 38(5): 608-13