CAJ | 학술논문

笔者成功诊治1例65岁男性抗中性粒细胞胞浆抗体（ANCA）相关性血管炎患者。该患者主要表现为慢性咳嗽和肺部游走性阴影，曾被诊断为淋巴细胞性间质性肺炎，激素治疗有效，病情复发后查MPO-ANCA阳性，结合肺穿刺活检明确诊断为ANCA相关性血管炎，加用糖皮质激素和环磷酰胺后病情再次缓解。根据文献报道和笔者的临床经验，ANCA相关性血管炎临床表现复杂，缺乏特异性，常被误诊。呼吸科医师对ANCA相关性血管炎肺部受累特点应熟悉，要重视血清ANCA的筛查，以便于本病的早期诊断。
필자성공진치1례65세남성항중성립세포포장항체（ANCA）상관성혈관염환자。해환자주요표현위만성해수화폐부유주성음영，증피진단위림파세포성간질성폐염，격소치료유효，병정복발후사MPO-ANCA양성，결합폐천자활검명학진단위ANCA상관성혈관염，가용당피질격소화배린선알후병정재차완해。근거문헌보도화필자적림상경험，ANCA상관성혈관염림상표현복잡，결핍특이성，상피오진。호흡과의사대ANCA상관성혈관염폐부수루특점응숙실，요중시혈청ANCA적사사，이편우본병적조기진단。
We reported a successful diagnosis and treatment of a 65-year-old male patient with pulmonary lesion caused by antineutrophil cytoplasmic antibody (ANCA) associated vasculitis. The main manifestations of the patient were chronic cough and pulmonary migratory shadows. He was once diagnosed as lymphocytic interstitial pneumonia, and received effective corticosteroid mono-treatment. MPO-ANCA was positive after the disease relapsed, and ultimately, the diagnosis of ANCA associated vasculitis was made after lung puncture biopsy. After combination administration of corticosteroid and cyclophosphamide, all signs and symptoms were relieved. According to literature and our clinical experience, ANCA associated vasculitis had complex, non-specific clinical manifestations, and thus, was often misdiagnosed. In order to facilitate the early diagnosis of this disease, respiratory physicians should be familiar with the characteristics of the pulmonary involvement of ANCA associated vasculitis, and pay more attention to serum ANCA screening.