Swyer-James syndrome mimicking pulmonary thromboembolism in a patient with microscopic polyangiitis |
Jeena Park, Seung Yeon Na, Yeon-Ah Lee, Sang-Hoon Lee, Seung-Jae Hong, Hyung-In Yang |
Cardiology Division, Department of Internal Medicine, Yeungnam University Hospital1 |
증례 : 현미경적 다발성 혈관염 환자에서 폐색전증으로 오인되었던 Swyer-James 증후군 |
박지나나승연이연아이상훈홍승재양형인, Seung Yeon Na, Yeon-Ah Lee, Sang-Hoon Lee, Seung-Jae Hong, Hyung-In Yang |
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Abstract |
A 66-year-old man was admitted to our institution with a one-month history of benumbed extremities and a small
amount of hemoptysis. Laboratory findings showed microscopic hematuria and proteinuria along with a positive P-ANCA
test. The third day after admission, he developed dry gangrene and motor weakness in the upper and lower extremities.
Nerve biopsy demonstrated leukocytoclastic vasculitis. Microscopic polyangiitis was diagnosed based on clinical and
pathological clues. Despite sufficient oxygen therapy, his respiratory status suddenly deteriorated, and the possibility of
pulmonary thromboembolism was suggested. Pulmonary perfusion scintigraphy showed markedly decreased perfusion in
the right lung. However, chest CT revealed hypoplasia of the left pulmonary artery and hyperlucency on the left lung,
which are consistent with Swyer-James syndrome, a non-filling defect in the pulmonary arteries. There has been no
report of a case of Swyer-James syndrome accompanied by MPA. We here report a case of Swyer-James syndrome
mimicking pulmonary thromboembolism in a patient with microscopic polyangiitis.(Korean J Med 73:S1095-S1100, 2007) |
Key Words:
Microscopic polyangiitis, Swyer-James syndrome |
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