Wegener's granulomatosis associated to hashimoto thyroiditis: Anatomo-clinical correlation in a case with necropsy
Keywords:
Wegener's granulomatosis, acute medium otitis, hashimoto thyroiditis, necropsy, anatomo-clinical correlationAbstract
Wegener's granulomatosis is defined as a vasculitis with systemic involvement, affecting the airways and kidneys in most cases. It is suggested that its mechanism of injury is through autoimmune phenomena, with the presence of anti-neutrophil cytoplasmic antibodies in the serum of affected patients.
This report describes a case of Wegener's granulomatosis that rapidly progressed to death, with acute otitis media as the first manifestation, in addition to the coexistence of Hashimoto's thyroiditis, manifested by hypothyroidism. The association of other autoimmune diseases is rarely reported and this fact suggests the existence of some common regulatory phenomenon.
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Silverberg SG, et ai. Principies and practice of surgical pathology and cytopathology. 3rd ed. New York: Churchill Livingstone; 1997. v.2.
Roberts T, Colby TV. Noninfectious Necrotizing Granulomatous Disorders. ln: Spencer H, Hasleton PS. Spencer's pathology of the Jung. 5th ed. London: McGraw Hill; 1996. p.835-63.
Leavitt RY, et ai. The American College of Rheumathology 1990 C riteria for the C lassification of Wegener's granulomatosis. Arthritis and Rheumatism 1990; 33(8):1101-7.
De Remee RA, McDonald TJ, Harrison EG, Coles DT. Wegener's granulomatosis. Anatomic correlates, a proposed classification. Mayo Clin Proc 1976; 51(12):777-81.
Fernandes SEM, Samara AM. Granulomatose de Wegener: análise clínica e histopatológica. Rev Bras Reumatol 1991; 31(6):218-22.
Fienberg R, Mark EJ, Goodman M, McCluskey RT, Niles JL. Correlation of antineutrophil cytoplasmic antibodies with the extrarenal histopathology of Wegener's (Pathergic) Granulomatosis and related forms of vasculitis. Hum Pathol 1993; 24(2): 160-8.
Stone JH. Limited versus severe Wegener's granulomatosis: baseline data on patients in the Wegwner's granulomatosis etanercept triai. Arthritis Rheum 2003; 48(8):2299-309.
Mark EJ, Matsubara O, Tan-Liu NS, Fienberg R. The pulmonary biopsy in the early diagnosis of Wegener's (pathergic) granulomatosis: A study based on 35 open Jung biopsies. Hum Pathol 1988; 19(9):1065-71.
Travis WD, Hoffman SG, Leavitt RY. Surgical pathology of the lung in Wegener's granulomatosis. Am J Surg Pathol 1991; 51(4):315-33.
Galateau F, Loire R, Capron F. Pulmonary lesions in Wegener's disease. Report of the French anatomo-clinical research group. Study of 40 pulmonary biopsies. Rev Mal Respir 1992; 9:431-42.
Fienberg R. The Protracted Superticial Phenomenon in the Pathergic (Wegener's) Granulomatosis. Hum Pathol 1981; 12(5):458-67.
Masor JJ, Gal AA, Livolsi VA. Case Report: Hashimoto's thyroiditis associated with Wegener's granulomatosis. Am J Med Sei 1994; 308 (2):112-4.
Armbruster C, Vetter N. Wegener's granulomatosis with splenic involvement and Hashimoto's lymphomatous thyroiditis. Pneumologie 1991; 45(1):28-31.
Cotch MF, Fauci AS, Hoffman GS. HLA typingin patients with Wegener granulomatosis. Ann lntern Méd 1995; 122(8):635.
P apiha SS, Murty GE, Ad'Hia A, Mains BT, Venning M. Association of Wegener's granulomatosis with HLA antigens and other genetic markers. Ann Rheum Dis 1992; 51(2):246-8.
Lahoz ZMT, Martínez SJ, Martínez SG. Formas de presentacíon infrecuente de l,a enfermedad de Wegener. Acta Otorrinolaringol Esp 2003; 54(2): 102-6.
Hofmann T, Kainz J, Koc C, Smolle KH, Brunner G. lsolated unilateral otitis with facial nerve paralysis as initial symptom of Wegener granulomatosis. An unusual clinicai course. Laryngorhinootologie 1998; 77(6):352-4.
Atula T, Honkanen V, Tarkkanen J, Jero J. Otitis media as a sign of Wegener's granulomatosis in childhood. Acta Otolaryngol Suppl 2000; 543 48-50.
Banerjee A, Armas JM, Dempster JH, Dempster JH. Wegener's granulomatosis: diagnostic dilemma. J Laryngol Otol 2001; 115(1):46-7.
Almadori G, Trivelli M, Scarano E, Cadoni G. Misleading clinicai features in Wegener's granulomatosis. A case report. J Laryngol Otol 1997; 111(8):746-8.
Hartl DM, A1dan P, Brugiére O, Sterkers O. Wegener's granulomatosis presenting as a recurrence of chronic otitis media. Am J Otolaryngol 1998; 19(1 ):54-60.
Leibecke RR, Schwartz W lnitial otologic manifestation of Wegener's granulomatosis. HNO 1994; 42(2): 119-22.