Microscopic polyangiitis as etiology for lung fibrosis - A known but often late-diagnosed cause;Mikroskopische polyangiitis als ätiologischer faktor der lungenfibrose - Eine bekannte, doch häufig spät diagnostizierte ursache

Medizinische Klinik

Volumn 104, Issue 6, 2009, Pages 476-479

  Gompelmann, Daniela Rosa ^a   Wenz, Heinrich ^a   Heußel, Claus Peter ^b   Herth, Felix J ^a  

^a Abteilung Pneumologie   (Germany)

^b DKFZ Heidelberg   (Germany)

Author keywords

ANCA; Lung fibrosis; Microscopic polyangiitis; MPO

Indexed keywords

AUTOANTIBODY; AZATHIOPRINE; CYCLOPHOSPHAMIDE; GLUCOCORTICOID; LEFLUNOMIDE; METHOTREXATE; NEUTROPHIL CYTOPLASMIC ANTIBODY; STEROID;

AGED; ANTIBODY TITER; ARTICLE; BLOOD GAS ANALYSIS; CASE REPORT; CLINICAL EXAMINATION; COMPUTER ASSISTED TOMOGRAPHY; CONSERVATIVE TREATMENT; COUGHING; DISEASE SEVERITY; DRUG DOSE REDUCTION; DRUG TREATMENT FAILURE; DYSPNEA; GENERAL CONDITION DETERIORATION; HEMOPTYSIS; HUMAN; LABORATORY TEST; LUNG ALVEOLITIS; LUNG FIBROSIS; LUNG FUNCTION TEST; MALE; MICROSCOPIC POLYANGIITIS; PROTEINURIA; RESPIRATORY FAILURE; THORAX RADIOGRAPHY; TREATMENT OUTCOME; URINALYSIS;

AGED; ANTIBODIES, ANTINEUTROPHIL CYTOPLASMIC; DIAGNOSIS, DIFFERENTIAL; DYSPNEA; HUMANS; IMMUNOSUPPRESSIVE AGENTS; LUNG; MALE; PEROXIDASE; POLYARTERITIS NODOSA; PULMONARY FIBROSIS; RESPIRATORY FUNCTION TESTS;

RHEUM;

EID: 67650730509     PISSN: 07235003     EISSN: None     Source Type: Journal    
DOI: 10.1007/s00063-009-1097-4     Document Type: Article

References (11)

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6. A.T. Masi G.G. Hunder J.T. Lie 1990 The American College of Rheumatology criteria for classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis) Arthritis Rhe in the past had not led to an adequate diagnosis and treatment. Clinical and laboratory examination in the authors' hospital showed normal findings apart from suspicion of chronic tonsillitis, confirmed by an ENT specialist. Therefore, tonsillectomy was performed. Histopathology revealed chronic tonsillitis with tonsillar actinomycosis but no other disease. 6 months after tonsillectomy the patient presented asymptomatic and comfortable. Oral malodor was no longer detectable. Conclusion: Oral malodor has a broad differential diagnosis including chronic tonsillitis caused by Actinomyces species and concomitant anaerobic bacteria able to produce volatile sulphur compounds and other putrefactive molecules. Therapeutic gold standard in symptomatic disease is tonsillectomy, lacking comparative studies on the success rates of conservative antibiotic therapy, e.g., with aminopenicillins plus β-lactamase inhibitor for several weeks or months. This case presentation illustrates that anticipated internal disease with an agonizing and prolonged cause of disease could be solved by tonsillectomy. © 2009 Urban & Vogel, Muenchen.
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