抗中性粒细胞胞浆抗体阴性肉芽肿性多血管炎1例报告并文献复习  

Seronegative granulomatosis with polyangiitis: a case report and literature review

作　　者：陈虹[1] 吴兰雁[1] 郑广宁[1] 林梅[1] Chen Hong;Wu Lanyan;Zheng Guangning;Lin Mei(State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept.of Oral Medicine,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院口腔黏膜病科

出　　处：《国际口腔医学杂志》2019年第4期426-430,共5页International Journal of Stomatology

摘　　要：肉芽肿性多血管炎(GPA)是一种以血管炎及坏死性肉芽肿为主要特征的全身系统性疾病。该病的临床表现复杂、多变,诊断需结合临床症状体征、抗中性粒细胞胞浆抗体(ANCA)检测及组织病理学检查结果。口腔草莓状牙龈损害是少见的黏膜病损。本文记录了1例仅有口腔和鼻腔损害的50岁男性藏族患者的诊断过程,其非典型的临床表现及ANCA阴性结果为诊断带来了较大的困难。旨在提醒广大医疗工作者在遇到相似临床表现时不应忽视GPA的排查。对局部口腔病变的早期诊断、早期治疗有重要临床价值,有助于改善患者的预后,对延缓病情进展有重要意义。Granulomatosis with polyangiitis (GPA) is a systemic vasculitis and necrotising glomerulonephritis.The clinical manifestations of this condition are complex and varied, and the diagnosis requires the combined results of clinical symptoms, anti-neutrophil cytoplasmic antibody (ANCA) detection and histopathological examination.Strawberry gingivitis of GPA is rarely the reason of initial clinical presentation that is similar to inflammatory and infective diseases. This paper reports the case of a 50-year-old Chinese Tibetan patient with diagnostically difficult, ANCA-negative GPA that initially presented with oral and nasal manifestations only.The aim of this study is to remind dentists the possibility of GPA when faced with similar clinical manifestations.Moreover, early diagnosis and treatment play an important role in the improvement and prognosis of patients with GPA.

关 键 词：肉芽肿性多血管炎 病例报道 文献分析 抗中性粒细胞胞浆抗体 

分 类 号：R781.59[医药卫生—口腔医学]