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| 급성신부전과 특발성 기흉이 발생한 Wegener씨 육아종증 1예 (A Case of Wegener`s Granulomatosis with Acute Renal Failure and Pneumothorax Developed during Treatment with Immunosuppressive Agent) |
| 박성재, 하희근, 김양욱, 김주인, 김영훈, 윤혜경 (Sung Jae Park, Hi Gun Ha, Yang Wook Kim, Joo In Kim, Yeong Hoon Kim and Hye Kyoung Yoon) |
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| Abstract |
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Wegener's granulomatosis is characterized by necrotizing granulomatosis lesion of the respiratory tract, glomerulonephritis and frequently vasculitis involving other organs. The basic pathophysiologic mechanism of Wegener's granulomatosis is not defined yet. However, it may be suspected an autoimmune disease.
We experienced a case of Wegener's granulomatosis which are associated with acute renal failure and pneumothorax.
The patient suffered from hemoptysis, fever and cough. Despite antibiotic therapy, symtoms did not improved and multiple varying sized nodules were aggravated on chest roentogenogram and serum creatinine elevated 3.4mg/dl. After diagnosis using video associated thoracoscopic surgery, the patient was treated with cyclophsphamide, glucocorticoid and sulfamethoxasole-trimethoprime. With the combination therapy, the patient felt completely well and chest roentogenogram showed lungs were improved and serum creatinine was normal. The patient was readmitted because of right pleuritic pain and dyspnea 15 day after discharge. The patient was developed a right pneumothorax. The lung was easily expanded by intercostal tube drainage with a one way valve. The patient has been treated as an out- patient with immunosuppressive agents continously. |
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