[Wegener's granulomatosis overlapped with Takayasu arteritis complicated by thrombosis of the internal jugular vein].
A 30 year-old woman with Wegener's granulomatosis with typical lesions of nose, mouth, skin, lung and positive c-ANCA titre was admitted to our hospital because of ineffective treatment with corticosteroids and cyclophosphamide. Infiltration of the left side of chest wall and collateral circulation were seen during physical examination. Ultrasound examination revealed thrombus in the left internal jugular vein and in the left subclavicular vein. Angio CT revealed parenchymal infiltration in the lower right lobe, thrombi in segmental arteries in this area and enlarged mediastinum. MRI examination revealed thickened aorta wall to 25 mm with its contrast enhancement. It suggested inflammatory infiltration of aorta arcus and its branches. This picture was similar to early stages of Takayasu arteritis but our patient had no typical clinical symptoms related to narrowing or obliteration of large arteries. We recognised Wegener's granulomatosis with overlapped Takayasu arteritis with thrombosis of jugular vein and pulmonary thrombosis. In differential diagnosis: Wegener's granulomatosis with large arteries involvement is taken into account. Treatment with cyclophosphamide and prednisolone was effective.
Wiatr
Elzbieta
E
III Kliniki Chorób Płuc, Warszawie.
Dobkowski
Piotr
P
Opoka
Lucyna
L
Drygalska-Pozorońska
Alicja
A
Orłowski
Tadeusz
T
Langfort
Renata
R
Kurzyna
Marcin
M
Demkow
Urszula
U
Roszkowski-Sliz
Kazimierz
K
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D017023:Coronary Angiography; D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007601:Jugular Veins / Q000000981:diagnostic imaging*; D018810:Magnetic Resonance Angiography; D011239:Prednisolone / Q000008:administration & dosage; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000188:drug therapy; D013625:Takayasu Arteritis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone