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Mass‐Forming Variants in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis: Diagnostic Complexities in Granulomatous Disease. A Case Report

Title: Mass‐Forming Variants in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis: Diagnostic Complexities in Granulomatous Disease. A Case Report
Authors: Benedetta Fazzi; Elena Treppo; Simone Longhino; Maria Pillon; Luca Quartuccio
Source: ACR Open Rheumatology, Vol 7, Iss 4, Pp n/a-n/a (2025)
Publisher Information: Wiley
Publication Year: 2025
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: Diseases of the musculoskeletal system; RC925-935
Description: A middle‐aged woman presented with a granulomatous breast lesion in 2018. By 2021, antibiotic‐resistant pneumonia led to the discovery of granulomatous inflammation in the lung and thyroid. Initially misdiagnosed as Erdheim–Chester disease (ECD), she was treated with interferon without success. Histopathology later ruled out ECD, suggesting an unspecified granulomatous disease, with granulomatosis with polyangiitis (GPA) initially excluded due to negative antineutrophil cytoplasmic antibodies (ANCAs) and foamy histiocytes. In 2023, repeated lung biopsy and PR3‐ANCA positivity led to a revised diagnosis of mass‐forming GPA. Rituximab therapy resulted in remission. This case highlights the diagnostic complexity of GPA with atypical histopathological features.
Document Type: article in journal/newspaper
Language: English
Relation: https://doi.org/10.1002/acr2.70038; https://doaj.org/toc/2578-5745; https://doaj.org/article/8b2dbf9663324fdb85d48b619a37a7e3
DOI: 10.1002/acr2.70038
Availability: https://doi.org/10.1002/acr2.70038; https://doaj.org/article/8b2dbf9663324fdb85d48b619a37a7e3
Accession Number: edsbas.9991EC55
Database: BASE