Abstract:
Objective To study the clinical characteristics,diagnostic and treatment methods of Wegener’s granuloma(WG).
Methods Clinical data about 101 WG patients were retrospectively analyzed.
Results Of the 101 WG patients,51 were males and 50 were females at the age of 8-75 years(42.7±16.0 years),72.3% of them were admitted to our hospital because of fever and fatigue.The involved organs were lungs(67.3%),followed by ear,nose,and throat(62.4%),eyes(47.5%),kidneys(26.7%),nervous system(18.8%),skin(14.9%),muscle and joints(14.9%),Abdomin(12.9%),mucous membrane of mouth(8.9%),and cardiovascular system(6.9%).Of the 101 WG patients,90 underwent biopsy with a positive rate of 79.4%,97 received serological test of antineutrophil cytoplasmic antibodies(ANCA) with a positive rate of 79.4%,and 24(23.8%) were misdiagnosed before admission.All the patients were treated with glucocorticoids and/or cytotoxic immunosuppressive agents.Twenty-four patients were admitted to hospital over 2 times due to relapse of the disease.Three patients died of respiration failure due to pulmonary infection,2 patients required dialysis due to acute renal failure,and 5 patients(6 eyes) suffered from visual loss due to delayed treatment.The symptoms of other patients were significantly improved.
Conclusion WG involves multiple organs,especially lungs,ear,nose,throat and eyes.Its clinical manifestations are complicated,its early diagnosis is difficult,its recurrence rate is rather high,its diagnosis and treatment require the assist from different departments,and prompt treatment improves its prognosis.