Poster Session : PS 1232 ; Pulmonology : Granulomatosis with Polyangitis (Wegener`s Granu-lomatosis) Presenting as Necrotizing Pneumonia

저작시기 2014.01 |등록일 2015.01.05 | 최종수정일 2015.04.23 파일확장자어도비 PDF (pdf) | 1페이지 | 가격 1,000원
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발행기관 : 대한내과학회 수록지정보 : 대한내과학회 추계학술발표논문집 / 2014권 / 1호
저자명 : ( Yu Jin Yang ) , ( Tae Hoon Lee )

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Backgrounds: WG (WG) is an autoimmune, necrotizing granulomatous disease of unknown etiology that affects medium and small vessel and it is characterized with vasculitis of upper and lower respiratory tract or glomerulonephritis. Most common feature in radiologic finding of WG is multiple, bilateral cavitary nodules. But its radiologic findings of Chest CT can be variable. Therefore, the diagnosis of WG is challenging if its radiologic feature is not typical and its clinical presentation is obscure. Case report: Previous healthy 64-year-old woman was presented with typical pneumonia symptom like cough, sputum and febrile sensation. Imaging finding was Rt lower lobe consolidation which suggests typical bacterial pneumonia. But she did not respond to empirical braod antibiotics. To exclude malignancy, we did BFS and EBUS biopsy repeatedly. Unexpectedly, it failed to show diagnostic clues including biopsy and microlobiological results. As time went by, her symptoms got aggravated. To make the diagnosis clear, She underwent VATS biopsy, which finally turned out WG. Discussion: Typical chest X ray finding of WG is round nodules with de. nitive border or in. ltration which involve both lung lobes. The patient in this report was atypical in that she presented with a large consolidation confined to Left lower lung lobe while most nodular lesions in WG appear multifocally and bilaterally. However, atypical chest x ray finding like consolidaiton, pleural thickening, pleural effusion and atelectasis can be observed in WG. It cannot give de. nitive clue for diagnosing WG. We present the case of WG which was dif. cult to diffentiate with lung cancer and pneumonia. In the setting which can be confused with antibiotics refractory pneumonia or malignancy of lung. We can suspect WG and do open lung biopsy.

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      Poster Session : PS 1232 ; Pulmonology : Granulomatosis with Polyangitis (Wegener`s Granu-lomatosis) Presenting as Necrotizing Pneumonia
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