误诊为原发性甲状腺功能亢进合并肺部感染、重度贫血的抗中性粒细胞胞浆抗体相关性血管炎1例  

A case of anti-neutrophil cytoplasmic antibody-associated vasculitis misdiagnosed as primary hyperthyroidism complicated with pulmonary infection and severe anemia

作　　者：金更学 胡雪剑[1] 徐翔宇[1] 陈慧[1] JIN Gengxue;HU Xuejian;XU Xiangyu;CHEN Hui(Department of Endocrinology and Metabolism,Lanzhou University Second Hospital,Gansu,Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院内分泌代谢科,甘肃兰州730000

出　　处：《中国医药科学》2022年第12期197-200,共4页China Medicine And Pharmacy

摘　　要：丙基硫氧嘧啶(PTU)诱发的抗中性粒细胞胞浆抗体相关性血管炎(AAV)是以一组自身免疫介导的炎症性疾病,以系统性小血管炎为主要特点,病理学方面可分为显微镜下多血管炎、肉芽肿性血管炎和嗜酸性肉芽肿性血管炎。该疾病临床表现多样,为多系统受累,最常受累的器官是肺和肾,涉及内分泌代谢科、风湿免疫科、呼吸科、泌尿科等多种学科,治疗上以糖皮质激素和免疫抑制剂为主。但目前该疾病尚未被广泛认知,往往延误诊断,影响治疗和预后。现报道1例兰州大学第二医院内分泌代谢科收治的PTU诱发的AAV,通过分析讨论本病例的诊治特点并文献复习,为PTU诱发的AAV的早期诊断和治疗提供思路,以期对临床工作有所帮助。Propylthiouracil(PTU)-induced anti-neutrophil cytoplasmic antibody-associated vasculitis(AAV)is a group of autoimmune-mediated inflammatory diseases.It is mainly characterized by systemic vasculitis,which can be divided into microscopic polyangiitis,granulomatous vasculitis and eosinophilic granulomatosis with polyangiitis from the aspect of pathology.The clinical manifestation of this disease is diverse,involving multiple systems.The most frequently involved organs are lung and kidney,involving multiple departments such as the department of endocrinology and metabolism,department of rheumatology and immunology,department of respiration,department of urology,etc.Glucocorticoids and immunosuppressants are the main treatments.However,at present,the disease has not been widely recognized,which often delays the diagnosis and impacts the treatment and prognosis.A case of PTU-induced AAV admitted to and treated in the department of endocrinology and metabolism of the Lanzhou University Second Hospital is reported.By analyzing and discussing the diagnosis and treatment characteristics of this case and reviewing the literature,ideas were provided in this paper for the early diagnosis and treatment of PTU-induced AAV,so as to be h elpful for the clinic work.

关 键 词：丙基硫氧嘧啶 甲状腺功能亢进 血管炎 抗中性粒细胞胞浆抗体 

分 类 号：R581.1[医药卫生—内分泌]