以头痛为首发症状的ANCA相关性血管炎1例

ANCA-Associated Vasculitis with Headache as First Symptom:A Case Report

ANCA相关性性血管炎及中枢神经系统血管炎均可表现为中枢神经系统血管炎症。但中枢神经系统血管炎仅存在中枢神经系统受累表现,而ANCA相关性性血管炎可出现全身多系统受累,二者在单纯出现中枢神经系统血管炎症表现时容易被混淆。通过报道1例以头痛为首发症状误诊为中枢神经系统血管炎的ANCA相关性血管炎患者的临床资料,结合文献进行分析总结,旨在提高对ANCA相关性血管炎和中枢神经系统血管炎临床表现和治疗方案选择的认识,拓展临床思维,提高诊治水平,有利于ANCA相关性血管炎的早期诊断、早期治疗及改善预后。

ANCA-associated vasculitis(AAV)and primary of angiitis of the central nervous system(PACNS)can manifest as central nervous system vascular inflammation.However,PACNS only present in central nervous system involvement,whereas AAV can occur in systemic multi-system involvement.These two diseases are easy to be confused in the presence of simple central nervous system vascular inflammation.This paper reports the clinical data of a patient with AAV who misdiagnosed as PACNS with headache as the first symptom,combined with literature analysis and summary,enhances the understanding of the clinical manifestations and treatment options of AAV and PACNS,in order to promote the clinical thinking and improve the level of diagnosis and treatment,which is conducive to early diagnosis,early treatment and improved prognosis of AAV.