ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2013, Vol. 22 ›› Issue (6): 580-584.

• 论文 • 上一篇    

反复发热、肺部结节、肾周自发血肿

  

  • 出版日期:2013-12-28 发布日期:2013-12-28

Renal Aneurysm in Granulomatosis with Polyangiitis

  • Online:2013-12-28 Published:2013-12-28

摘要:

摘要:46岁男性,以发热,肺部多发性结节起病,近半月血肌酐进行性升高。实验室检查提示蛋白尿,多形性镜下血尿,血清PR3-ANCA高滴度阳性。住院期间出现剧烈腹痛,血色素下降。腹部CT扫描提示右肾包膜下血肿。选择性肾动脉造影检查示双肾多发性动脉瘤,右肾动脉瘤破裂出血。诊断考虑ANCA相关性肉芽肿性血管炎伴肾动脉瘤破裂。

关键词: 肉芽肿性血管炎, 肾动脉瘤

Abstract:

 A 46-year-old manpresented with fever, bilateral pulmonary nodular infiltrates for 3 month, and oliguric renal failure for 15 days. The urine analysis revealed proteinuria and haematuria, and PR3-ANCAs were positive detected by ELISA. He complained of a sharp pain with sudden onset in his right side, and a drop in haemoglobin developed in the subsequent hours. Abdominal CT scan revealed a large right-sided perinephric haematoma. A selective arterial angiography showed multiple impressive aneurysms in renal arteries, active bleeding was present in right. The final diagnosis was granulomatosis with polyangiitis and rupture of renal arterial aneurysm.

Key words: granulomatosis with polyangiitis, renal aneurysm