Sažetak
Apstrakt
Uvod. Wegener-ova granulomatoza je oboljenje koje karakterišu granulomatozna inflamacija gornjih i/ili donjih disajnih puteva, glomerulonefritis, uz različit stepen vaskulitisa malih krvnih sudova i nalaz c antineutrofilnih citoplazmatskih antitela (ANCA). U lečenju se koriste različiti modaliteti imunosupresivne terapije koji ne dovode uvek do remisije. Prikazana je efikasnost biološke terapije kod bolesnika sa refraktarnom formom Wegener-ove granulomatoze. Prikaz bolesnika. Bolesnik, star 23 godine, lečen je avgusta 2011. godine na Klinici za otorinolaringologiju i maksilofacijalnu hirurgiju Kliničkog Centra Srbije zbog gnojne upale srednjeg uva. U dva navrata je rađena masteidektomija, a sedmog dana nakon operacije došlo do pojave hemoptizije i febrilnosti. S ozirom na rendgentski snimak pluća na kome su viđene okrugle mekotkivne promene obostrano, laboratorijske analize koje su ukazale na nespecifični zapaljenski sindrom i pozitivne c ANCA (1 : 160) uz povišen titar antitela protiv proteinaze 3 (anti-PR3 antitela), postavljena je dijagnoza Wegener-ova granulomatoze. S obzirom na to da primena glikokortikoida, ciklofosfamida, imunomodulatorne doze imunoglobulina nisu doveli do kliničke remisije, odlučeno je da se primeni rituksimab. Nakon njegove primene uspostavljena je klinička remisija koja je trajala petnaest meseci. Zaključak. Primena biološke terapije može biti uspešna u lečenju bolesnika sa teškom refraktarnom formom granulomatoze sa poliangiitisom.
Ključne reči
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Reference
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