Avtor/Urednik     Remškar, Zlata; Logar, Dušan; Remškar, Janez; Kern, Izidor
Naslov     Wegenerjeva granulomatoza - prikaz dveh primerov
Prevedeni naslov     Wegener's granulomatosis - two case reports
Tip     članek
Vir     Zdrav Vestn
Vol. in št.     Letnik 68, št. 2
Leto izdaje     1999
Obseg     str. 95-8
Jezik     slo
Abstrakt     Background. Teo case reports of Wegener's granulomatosis are reported. The first patient had tipical clinical presentation of the disease, which made the diagnosis easy and led to an early treatment. In the second patient diagnosis of Wegener's granulomatosis was highly likely. It was based on the combination of untipical diagnostic parameters. The diagnosis was reached even harder due to concomitant active tuberculosis which evolved during the diagnostic procedure. It was due to reactivation of a postprimary tuberculos focus in the lungs of immunocompromized patient. Treatment of systemic vasculitis, more precisely defined as Wegener's granulomatosis, with cyclophosphamide and corticosteroids, stopped the progression of the disease in both patients. Treatment of tuberculosis in the second patient proceeded concomitantly without complications, and was prolonged due to immunodeficiency of the patient. Conclusions. We emphasize the importance of early recognition of Wegener's granulomatosis especially in the patients with untipical clinical course of the disease. Early treatment lead to significant clinical improvement. We believe the delay in diagnosis and treatment might have had, taking in account deteriorating kidney function, detrimental consequences for the patient.
Izvleček     Izhodišča. Prikazana sta dva bolnika, katerih bolezensko stanje smo opredelili za Wegenerjevo granulomatozo. Pri prvem prikazanem primeru je bila bolezen izražena značilno, kar je olajšalo diagnostični postopek in privedlo do zgodnjega ustreznega zdravljenja. Pri drugem prikazanem primeru pa je bila diagnoza Wegenerjeve granulomatoze zelo verjetna. Postavili smo jo na podlagi kombinacije netipično izraženih kazalnikov bolezni. Dodatno je diagnostiko osnovne bolezni zapletla v poteku bolezni diagnosticirana aktivna tuberkuloza, ki smo jo opredelili kot reaktivacijo postprimarnih žarišč v pljučih pri imunsko oslabljeni bolnici. Zdravljenje sistemskega vaskulitisa, podrobneje opredeljenega za Wegenerjevo granulomatozo, s ciklofosfamidom in kortikosteroidi je pri obeh bolnikih v razdobju opazovanja zaustavilo bolezensko dogajanje. Zdravljenje tuberkuloze v drugem primeru je potekalo sočasno in brez zapletov ter smo ga izvajali zaradi imunske oslabljenosti bolnice podaljšano. Zaključki. Poudarjena je pomembnost odločitve za diagnozo bolezni in netipično izraženem primeru, ki je vplivala na preobrat v do tedaj neugodnem poteku bolezni. Ocenjujemo, da bi lahko bilo odlašanje odločitve o diagnozi ob progredirajoči ledvični prizadetosti za bolnico škodljivo.
Deskriptorji     VASCULITIS, HYPERSENSITIVITY
WEGENER'S GRANULOMATOSIS
AGED