以眼部肿物为主要表现的抗中性粒细胞胞质抗体相关性血管炎1例  

A case of anti-neutrophil cytoplasmic antibodies-associated vasculitis with ocular masses as the main manifestation

作　　者：李啟俊 刘双信[2] 杨清华 王虹 李兰英[1] 莫方维 吕路[1] Li Qijun;Liu Shuangxin;Yang Qinghua;Wang Hong;Li Lanying;Mo Fangwei;Lyu Lu(Department of Nephrology,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,China;Department of Nephrology,Guangdong Provincial People's Hospital,Guangzhou 510080,China;Department of Medical Imaging,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,China;Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,China)

机构地区：[1]广东药科大学附属第一医院肾内科,广州510080 [2]广东省人民医院肾内科,广州510080 [3]广东药科大学附属第一医院医学影像科,广州510080 [4]广东药科大学附属第一医院呼吸与危重症医学科,广州510080

出　　处：《中华肾脏病杂志》2023年第3期220-223,共4页Chinese Journal of Nephrology

摘　　要：报道1例以眼部肿物为主要表现的抗中性粒细胞胞质抗体(anti-neutrophil cytoplasmic antibodies, ANCA)相关性血管炎(ANCA-associated vasculitis, AAV)病例。患者为中年女性, 初发症状为眼部肿胀, 眼部手术术前发现肺结节, 进一步检查发现有蛋白尿、血尿和肾功能不全, 肾脏病理示AAV肾损伤, 最终诊断为AAV引起的眼、肾及肺病变。经糖皮质激素和环磷酰胺治疗后, 眼、肾和肺病变均改善。AAV不典型临床表现可导致诊断延误, 原因不明的眼部肿物应注意排除AAV。A case of anti-neutrophil cytoplasmic antibodies(ANCA)-associated vasculitis(AAV)with ocular masses as the main manifestation was reported.The patient was a middle-aged female,the initial symptom was eye swelling,pulmonary nodules were found before eye surgery,and further examination revealed proteinuria,hematuria and renal insufficiency.Renal pathology showed ANCA-associated glomerulonephritis.The final diagnosis was eye,kidney and lung lesions caused by AAV.Treatment with glucocorticoids and cyclophosphamide resulted in improvement in eye,kidney,and pulmonary lesions.Atypical clinical manifestations of AAV may lead to delayed diagnosis,and attention should be paid to the exclusion of AAV for ocular masses of unknown cause.

关 键 词：抗中性粒细胞胞浆抗体相关性血管炎 眼 肉芽肿伴血管炎 眼部肿物 

分 类 号：R597[医药卫生—内科学]