Preview

South Russian Journal of Therapeutic Practice

Advanced search

Wegener's granulomatosis: difficulties in diagnosis and treatment

https://doi.org/10.21886/2712-8156-2023-4-4-95-100

Abstract

Granulomatosis with polyangiitis (Wegener's granulomatosis, GPA) is a rare disease of unknown etiology with multiple organ lesions, characterized by the development of necrotizing granulomatous inflammation and signs of autoimmune vasculitis, predominantly affecting small and medium-sized vessels. In the above clinical case, the patient has a classic triad of symptoms (damage to the upper respiratory tract, lungs, kidneys), the diagnosis was confirmed morphologically. The peculiarity of the described clinical case is its rare prevalence, the difficulty in making a diagnosis due to the multiorganism of the lesion, the absence of specific signs at the onset of the disease, which required a differential diagnosis. Early detection of antineutrophil cytoplasmic antibodies (ANCA) in the blood increases the frequency of GPA diagnosis, and timely diagnosis allows prescribing therapy as soon as possible and avoiding disability in patients.

About the Authors

Y. R. Baranova
State Health Institution “Regional Clinical Hospital”
Russian Federation

Yulia R. Baranova - pulmonologist in the Pulmonology Department, Regional Clinical Hospital.

Saratov



I. A. Romanova
V.I. Razumovsky Saratov State Medical University
Russian Federation

Irina A. Romanova - Cand. Sci. (Med), Associate Professor, Hospital Therapy Department, Saratov State Medical University named after V.I. Razumovsky Ministry of Healt of Russia.

Saratov



R. N. Steshenko
State Health Institution “Regional Clinical Hospital”
Russian Federation

Ruslan N. Steshenko - Cand. Sci. (Med), Head of the Pulmonology Department, Regional Clinical Hospital.

Saratov



I. F. Melehina
State Health Institution “Regional Clinical Hospital”
Russian Federation

Irina F. Melehina - Head of the Rheumatology Department, Regional Clinical Hospital.

Saratov



N. N. Nikitina
V.I. Razumovsky Saratov State Medical University
Russian Federation

Natalia M. Nikitina - MD, head of hospital therapy department of Federal State Educational Institution of High Education “Saratov State Medical University n.a. V.I. Razumovsky” Ministry of Health Russian Federation.

Saratov



N. A. Karoli
V.I. Razumovsky Saratov State Medical University
Russian Federation

Nina A. Karoli - MD, professor of hospital therapy chair of general medicine Department, V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of the Russia.

Saratov



References

1. Wegener F. Uber eine eigenartige rhinogene granulomatose mit besonderer beteiligung des arteriensystems und der nieveu. Beitr. Pathol. 1939;102:36-68.

2. Анаев Э.Х., Баранова И.А., Белевский А.С. Легочные васкулиты: диагностика и лечение. Тер. Арх. 2018;(3):99-106. DOI: 10.26442/terarkh201890399-106.

3. Zhou P, Ma J, Wang G. Impact of interstitial lung disease on mortality in ANCA-associated vasculitis: A systematic literature review and meta-analysis. Chron Respir Dis. 2021;18:1479973121994562. DOI: 10.1177/1479973121994562

4. Клименко С., Кривошеев О. Гранулематоз Вегенера на современном этапе: варианты течения, прогноз. Врач. 2005;12:39-41. eLIBRARY ID: 14306935; EDN: MBCBBH

5. Синенко А.А., Кулаков Ю.В., Абрамочкина Е.Б., Лупач Н.М., Сюсина О.И., Файзенгер Е.М., и др. Опыт ведения больного с гранулематозом Вегенера: трудности диагностики и лечения. Вестник современной клинической медицины. 2011;4(2):46a-51. eLIBRARY ID: 16404054; EDN: NUZFNN

6. Leavitt RY, Fauci AS, Bloch DA, Michel BA, Hunder GG, Arend WP, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis. Arthritis Rheum. 1990;33(8):1101-7. DOI: 10.1002/art.1780330807

7. Бекетова ТВ. Международные рекомендации по лечению АНЦА-ассоциированных системных васкулитов. Современная ревматология. 2019;13(1):19–25. doi: 10.14412/1996-7012-2019-1-19-25.

8. Stegeman CA, Tervaert JW, de Jong PE, Kallenberg CG. Trimethoprim-sulfamethoxazole (co-trimoxazole) for the prevention of relapses of Wegener's granulomatosis. Dutch Co-Trimoxazole Wegener Study Group. N Engl J Med. 1996;335(1):16-20. DOI: 10.1056/NEJM199607043350103


Review

For citations:


Baranova Y.R., Romanova I.A., Steshenko R.N., Melehina I.F., Nikitina N.N., Karoli N.A. Wegener's granulomatosis: difficulties in diagnosis and treatment. South Russian Journal of Therapeutic Practice. 2023;4(4):95-100. (In Russ.) https://doi.org/10.21886/2712-8156-2023-4-4-95-100

Views: 8570


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2712-8156 (Print)