Pneumothorax ingranulomatosis with polyangiitis:a case report and review of literature
10.3760/cma.j.issn.1007-7480.2016.09.010
- VernacularTitle:肉芽肿性多血管炎并发液气胸一例并文献复习
- Author:
Xuhua SHI
;
Yongfeng ZHANG
;
Li GU
;
Shu ZHANG
;
Yuewu LU
- Publication Type:Journal Article
- Keywords:
Vasculitis,central nervons system;
Pneumothorax
- From:
Chinese Journal of Rheumatology
2016;20(9):622-625
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the characteristics of granulomatosis with polyangiitis (GPA) accompanied by pneumothorax.Methods We described a case of GPA accompanied by hydropneumothorax who was successfully treated.Relevant literature was also reviewed.Results A total of 25 cases were identified,consisting of 18 males and 7 females [the average age was (44±16)(16-70) years old].The time from disease onset to pneumothorax was 26±51 (0.83-216) weeks.Pneumothorax,hydropneumothorax,pyopneumothorax and hemopneumothorax occurred in 11,5,8 and 1 respectively.Nodules or excavated nodules on chest radiography or CT were seen in 22 cases.Erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were elevated in all cases.Sixteen cases received glucocorticoid and immunosuppressive agents treatment.Sixteen cases received drainage and 7 received open operation.Pseudomonas aeruginosa was the most commonmicrobiology findings.Granulomatosis with active vasculitis,bronchopleural fistula,pleural bleb with intensefibrosis,rupture of subpleural nodule were seen on lung biopsy or autopsy.Nine cases died of infections,respiratory failure,sepsis and respiratory arrest.Conclusion Pneumothorax in GPA can be caused by multiple factors such as rupture of subpleural nodule and with high mortality.Patients always died of infections and respiratory failure.Regular treatment of the underlying disease,apply sensitive antibiotics for infection and reasonable surgical intervention should be considered.
