韦格纳肉芽肿并发高血糖症一例报告并文献复习

摘要

Objective To improve the recognition of Wegener’s granuloma(WG)combined with hyperglycemia.Methods Reviewing literature of the clinical data of one patient with Wegener’s granuloma combined with hyperglycemia and the relationship between Wegener’s granuloma and hyperglycemia was analyzed.Results CT guided lung biopsy was performed,and the pathological results were as the following:the granuloma was highly considered as Wegener’s granuloma.Check the cytoplasmic ANCA (cANC):positive,nuclear week type ANCA(pANCA):negative,anti-myeloperoxidase antibody <2.0, anti-proteinase 3 antibody 144.80.After admission,the preprandial glucose and postprandial blood glucose were found to be significantly higher than that of the normal,and the blood glucose returned to normal after the patient was treated with thehormone,cyclophosphamide and SMZ.Conclusion The reason of Wegener’s granuloma(WG)combined with hyperglycemia is possible that WG can cause the damage of pancreatic islet beta cell and decrease the secretion of insulin.%目的：提高对韦格纳肉芽肿（WG）并发高血糖症的认识。方法结合一例 WG 并发高血糖症患者的临床资料进行文献复习，对 WG 和高血糖症的内在联系进行分析。结果患者入院后在 CT 引导下行肺活检，病理检查结果提示：肉芽肿性炎，高度考虑为 WG。查胞浆型抗中性粒细胞胞浆抗体（cANCA）：阳性，核周型 ANCA（pANCA）：阴性，抗髓过氧化物酶抗体＜2．0，抗蛋白酶3抗体144．80。入院后监测血糖发现，餐前餐后血糖水平均明显高于正常，经激素＋环磷酰胺＋复方新诺明控制 WG 病情后血糖恢复正常。结论 WG 并发高血糖症原因可能为 WG 累及胰腺导致胰岛β细胞损伤、胰岛素内源性分泌减少。