Handan İNÖNÜ, Hasibe YEMENİCİ, Ayşe YILMAZ, Serpil ÖCAL, Zehra SEYFİKLİ, Engin SEZER

An unusual case of Wegener's granulomatosis with tongue involvement

Wegener granülomatozis, solunum yollarının nekrotizan granülomatöz lezyonları ve nekrotizan glomerülonefrit ile karakterize bir vaskülittir. Nazal, akciğer ve böbrek biyopsileri ve pozitif antinötrofilik sitoplazmik antikor (c-ANCA) analizi tanıda yardımcıdır. Erken tanı ve tedavi prognozda esastır. Dispne, öksürük, hemoptizi, halsizlik, iştah kaybı, gece terlemesi ve artraljisi olan 42 yaşında erkek hastada ağzın sublingual bölgesinde morumsu palpabl, purpurik lezyonlar tespit edildi. Göğüs grafisinde, her iki akciğer parankiminde nonhomojen infiltrasyon vardı. Toraks bilgisayarlı tomografide, sağ akciğer üst-orta loblarda yama dansitelerin yanı sıra her iki akciğer üst lobları tutan alveoler dansiteler vardı. Nazal mukoza biyopsisi güçlü destrüktif vaskülit gösterdi. c-ANCA pozitifti. Biz, dil tutulumu ve alveoler opasitelerin olduğu atipik akciğer radyolojisi olan nadir bir prezentasyonla karakterize Wegener granülomatozisli nadir bir olgu rapor ettik.

Dil tutulumu yapmış nadir bir Wegener granülomatözü

Wegener's granulomatosis is a type of vasculitis characterized by necrotizing granulomatosis respiratory tract lesions and necrotising glomerulonephritis. Nasal, lung and renal biopsies and positive antineutrophil cytoplasmic antibody (c-ANCA) analysis is helpful in diagnosis. Early diagnosis and treatment is critical in prognosis. A 42 years-old male had dyspnea, coughing, hemoptysis, fatigue, loss of appetite, night sweating and arthralgia. Violaceous palpable, purpuric lesions were detected on the sublingual region of the mouth. On chest X-ray, there was nonhomogeneous infiltration in the parenchyma of both lungs. There was alveolar density involving upper lobes of both lungs detected in thoracal computerized tomography as well as patchy densities on the right lung upper-middle lobes. A nasal mucosa biopsy showed strongly destructive vasculitis. c-ANCA test was positive. We report an unusual case with Wegener’s granulomatosis, characterized by a rare presentation of tongue involvement and atypical lung radiology with alveolar opacity.

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