OVERVIEW
Necrotizing nodular granulomatosis
Necrotizing nodular disease-like granulomatosis is a primary pulmonary granulomatous disease in which pathohistology reveals fused nodular or epithelioid granulomas with vasculitis and extensive necrosis.
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Department of Medicine
Respiratory Medicine
Synonyms: Necrotizing granuloma nodosum
Necrotizing nodular granulomatosis
Clinical Symptoms
Fever, cough, hemoptysis, chest pain, shortness of breath, etc.
Hazards
The disease is also a systemic vasculitis with significant necrotizing vasculitis if the lesions are actively progressive and may involve extrapulmonary tissues such as the eyes, brain, skin, skeletal muscle, peripheral nerves, and digestive tract.
Complications
Necrotizing vasculitis.
Examination
X-ray film, histopathologic examination.
Diagnosis
Diagnosis can be made on the basis of clinical manifestations such as fever, cough, hemoptysis, chest pain, shortness of breath, etc., combined with chest X-ray film and histopathologic examination.
Treatment principle
Symptomatic treatment, glucocorticoid treatment.
Curability
The disease has a good prognosis and can be spontaneously relieved. If there are multiple lesions, the prognosis is better if glucocorticoid treatment is adhered to.
Dietary advice
A light, easy-to-digest diet is recommended, avoiding spicy and irritating foods.
Etiology
Epidemiology
Most common in young and middle-aged women.
Etiology
The etiology is unknown. There are reports of fungal fragments found in the granulomas of this disease, suggesting that it may be a variant type of endogenous allergic alveolitis.
Symptoms and diagnosis
Typical symptoms
Typical symptoms are cough, fever, chest pain, gas and vinegar, malaise and weight loss. Symptoms are associated with extensive infiltrates or small nodules in the lungs. Some patients may be asymptomatic. Extrapulmonary organs are rarely involved, but occasionally the eyes, brain, skin, peripheral nerves, skeletal muscles and digestive tract may be involved.
Diagnostic basis
Patients present with clinical manifestations such as fever, cough, hemoptysis, chest pain, and shortness of breath. Chest X-ray examination shows multiple small nodules or infiltrates in both lungs or isolated unilateral small nodules in most patients; sometimes pulmonary infiltrates with cavity formation are seen. Typical pathologic changes found in lung biopsy can make the diagnosis.
Treatment
Treatment guidelines
Symptomatic treatment, glucocorticoid therapy.
Drug therapy
In case of multiple lesions, oral glucocorticoid therapy, commonly used prednisone, can be used, and the dosage is gradually reduced after the symptoms are relieved until the nodules in the lungs disappear completely.
Other treatments
For febrile symptoms, physical cooling or antipyretic drugs should be given.
Prognosis
The disease has a good prognosis and may resolve spontaneously. If multiple lesions appear, the prognosis is better if hormonal therapy is adhered to.
Nursing care
Daily care
Quit smoking and limit alcohol, pay attention to rest and avoid exertion. Keep the environment clean and hygienic, often open the window to ventilate and breathe fresh air, which is conducive to recovery. Maintain a happy mood.
Diet
Take a light, easy-to-digest diet, avoid spicy and stimulating food.