A Case of Limited Wegener's Granulomatosis with Hemophilia A, Complicated by Empyema, Bronchopleural Fistula and Herpes Zoster during Therapy.
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- Tao Yoshiaki
- Division of Respiratory Diseases, University of Occupational and Environmental Health
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- Hayashi Toshinari
- Division of Respiratory Diseases, University of Occupational and Environmental Health
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- Nagatomo Hiroko
- Division of Respiratory Diseases, University of Occupational and Environmental Health
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- Yoshii Chiharu
- Division of Respiratory Diseases, University of Occupational and Environmental Health
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- Nikaido Yoshihiko
- Division of Respiratory Diseases, University of Occupational and Environmental Health
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- Nagata Nobuhiko
- Division of Respiratory Diseases, University of Occupational and Environmental Health
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- Kido Masamitsu
- Division of Respiratory Diseases, University of Occupational and Environmental Health
Bibliographic Information
- Other Title
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- 膿胸，気管支ろうおよび帯状ほう疹をきたした血友病をもつ限局性Ｗｅｇｅｎｅｒ肉芽腫症の１例
Abstract
A 36-year-old man with hemophilia A was admitted to hospital because of otalgia, hearing loss, nasal obstruction, nonproductive cough, and high fever. His laboratory data showed high-grade acute inflammatory reactions. His chest X-ray and CT films showed multiple cavitary masses in the right lower lung field. Bronchoscopy performed at our institution revealed bronchial nodules in the intermediate truncus, and BAL revealed increases in the neutrophils and an IgG index (BAL IgG/albumin divided by serum IgG/albumin). Biopsy speciemens obtained from nasal mucosa showed epithelioid granulomas with Langerhans' giant cells and necrotizing vasculitis. Antineutrophil cytoplasmic antibodies were also positive, but no evidence of glomerulonephritis was observed. The diagnosis of limited Wegener's granulomatosis was thus made. He was treated with standard therapy (daily cyclophosphamide and glucocorticoids), but within 1 month he had complications of empyema with herpes zoster, and bronchopleural fistula. The complications resolved with appropriate treatment.
Journal
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- The Japanese journal of thoracic diseases
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The Japanese journal of thoracic diseases 32 (11), 1073-1077, 1994
The Japanese Respiratory Society