pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2015-25-6-753-756pulmo-656Research ArticleЗАМЕТКИ ИЗ ПРАКТИКИPRACTICAL NOTESГранулематоз с полиангиитом: астмаподобное и псевдопневмоническое начало болезниGranulomatosis with polyangiitis manifested with asthma-like syndrome followed by pneumonia6like syndromeТретьяковА. Ю.Tret'yakovA. Yu.

д. м. н., профессор ФГАОУ ВПО «Белгородский государственный национальный исследовательский университет»; тел.: (4722) 301379

MD, Professor, Federal Belgorod National Research University, Belgorod, Russia; tel.: (4722) 301379

opensource2007@yandex.ruЗахарченкоС. П.ZakharchenkoS. P.

к. м. н., старший научный сотрудник ФГАОУ ВПО «Белгородский государственный национальный исследовательский университет»; тел.: (4722) 301379

PhD, Senior Researcher at Federal Belgorod National Research University; tel.: (4722) 301379

openbox2013@yandex.ruШиленокВ. Н.ShilenokV. N.

к. м. н., зам. главврача по медицинской части Центр медицинской диагностики «Томограф»; тел.: (4712) 732000

PhD, Deputy Chief Medical Officer at Medical Diagnostic Center “Tomograph”; tel.: (4712) 732000

ФГАОУ ВПО «Белгородский государственный национальный исследовательский университет»: 308015, Белгород, ул. Победы, 85РоссияFederal Belgorod National Research University: 85, Pobedy str., Belgorod, 308015, RussiaRussian FederationООО Центр медицинской диагностики «Томограф»: 305018, Курск, ул. Дружбы, 4РоссияMedical Diagnostic Center “Tomograph”: 4, Druzhby str., Kursk, 305018, RussiaRussian Federation201528022016256753756Copyright © Третьяков А.Ю., Захарченко С.П., Шиленок В.Н., 20162016Третьяков А.Ю., Захарченко С.П., Шиленок В.Н.Tret'yakov A.Y., Zakharchenko S.P., Shilenok V.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/656

Представлено описание случая гранулематоза с полиангиитом, характеризовавшегося трехлетним пароксизмальным астмаподобным симптомокомлексом (на фоне гранулематозных изменений в подскладочном пространстве гортани), последующей трансформацией в многофокусное деструктивное поражение легких (при отсутствии клинических признаков гломерулонефрита) с положительным терапевтическим ответом при назначении комбинированного лечения цитостатическим препаратом, ритуксимабом, системными глюкокортикостероидами.

A case of granulomatosis with polyangiitis is described in the article. The patient experienced 3year paroxysmal asthmalike syndrome with granulomatous lesion of the subglottic portion of the larynx that further developed into multifocal destructive lesions of the lungs without clinical signs of glomerulonephritis and with positive response to combined therapy with cytostatic agents, rituximab and systemic steroids. The main criteria of granulomatosis with polyangiitis in this patient were high levels of ANCA and antiproteinase3 antibodies. Therefore, granulomatosis with polyangiitis is characterized by polymorphic onset of lung disease with coexisting paroxysmal respiratory syndrome, infiltrative and destructive pulmonary lesions.

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The authors declare that there are no conflicts of interest present.