以听力下降为首发症状合并急性肾损伤的肉芽肿多血管炎误诊一例及文献复习

doi:10.3877/cma.j.issn.1674-0785.2019.10.017

中华临床医师杂志(电子版) ›› 2019, Vol. 13 ›› Issue (10) : 787 -789. doi: 10.3877/cma.j.issn.1674-0785.2019.10.017

所属专题：经典病例；文献；

病例报告

以听力下降为首发症状合并急性肾损伤的肉芽肿多血管炎误诊一例及文献复习

鲍文璟¹, 伍刚²^,^†(

), 武杏¹

^1. 225002　扬州大学附属苏北人民医院　江苏省苏北人民医院肾脏内科；116023　大连医科大学研究生院
^2. 225002　扬州大学附属苏北人民医院　江苏省苏北人民医院肾脏内科

收稿日期:2019-04-14 出版日期:2019-05-15
通信作者: 伍刚

Granulomatous polyangiitis complicated with acute renal injury with hearing loss as initial symptom: a case report and literature review

Wenjing Bao¹, Gang Wu²(), xing Wu¹

Received:2019-04-14 Published:2019-05-15
Corresponding author: Gang Wu

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图1、2 肉芽肿多血管炎的鼻腔内肉芽肿性炎性病变　肉芽组织内可见大量中性粒细胞、浆细胞等炎性细胞及少许嗜酸性粒细胞浸润（箭），图1为低倍镜（HE染色，×100），图2为高倍镜（HE染色，×400）

图4 肉芽肿多血管炎的胸部CT示左肺下叶结节（箭）

图5~7 肉芽肿多血管炎的肾脏病理图　图5示HE染色高倍镜（×100）下，肾间质内可见肉芽肿性炎性病变，伴有单核细胞、中性粒细胞、浆细胞等炎性细胞及少许嗜酸性粒细胞浸润（箭）；图6示PAS染色高倍镜（×400）下，肾小球内有细胞性新月体形成；图7示在PASM染色高倍镜（×400）下，肾小球内可见纤维性新月体

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