Granulomatose de Wegener e estenose subglótica: descrição de caso

Abstract

Descreve-se o caso de um paciente com Granulomatose de Wegener, em tratamento com esteróides e ciclofosfamida, que, apesar do tratamento, evoluiu com dispnéia progressiva e rouquidão. A investigação mostrou tratar-se de uma estenose subglótica, sendo a dispnéia prontamente aliviada com a traqueostomia. São discutidos diagnósticos diferenciais e modalidades de tratamentos de estenose subglótica em portadores de Wegener.

Prevalência das manifestações clínicas iniciais da granulomatose de Wegener no Brasil: relato de seis casos e revisão da literatura

“…Table 4 shows the initial presentation of WG in adults by organs and systems, comparing two Brazilian studies and an international reference. 2,[19][20][21][22][23][24][25][26][27][28][29][30]32,35,[38][39][40]42,44,49,50 Some particularities of the patients seen at HGF should be mentioned: 1) the first patient developed paresthesia in the lower limbs with electroneuromyography showing axonal mononeuropathy of the posterior tibial nerve, a rare symptom in the initial phase of WG.…”

Pseudotumor pulmonar como apresentação inicial de granulomatose de Wegener

“…Two of the following criteria, accompanied by positive ANCA-c, confirm the diagnosis: oral or nasal inflammation; nodules or fixed opacities or cavitation on chest X-rays; microscopic hematuria or more than 5 erythrocytes per high-power microscopic field; and a biopsy finding of granulomatous inflammation (in the arterial wall or the perivascular/extravascular region of arteries and arterioles). (7,8) The presence of two or more criteria confers 88.2% sensitivity and 92.0% specificity. (7) The classical treatment for WG includes prednisone (1 mg/kg/day), accompanied by cyclophosphamide (2-3 mg/kg/day), for 4 to 6 weeks, the cyclophosphamide dose being adjusted according to the lymphocyte count (which should be maintained at approximately 1,000 cells/mm 3 ) and the prednisone being tapered over the subsequent 6 months.…”

“…(7,8) The presence of two or more criteria confers 88.2% sensitivity and 92.0% specificity. (7) The classical treatment for WG includes prednisone (1 mg/kg/day), accompanied by cyclophosphamide (2-3 mg/kg/day), for 4 to 6 weeks, the cyclophosphamide dose being adjusted according to the lymphocyte count (which should be maintained at approximately 1,000 cells/mm 3 ) and the prednisone being tapered over the subsequent 6 months. (1,8) We describe a case of WG with an uncommon initial presentation-a single tumor in the right lung.…”