多発血管炎性肉芽腫症に合併した気胸

Surgical Treatment for Pneumothorax with Granulomatosis with Polyangiitis

多発血管炎性肉芽腫症（granulomatosis with polyangiitis：GPA）は本邦で2,176例1）の罹患者が報告されている指定難病である．一方，GPAに気胸を合併することはまれとされている．われわれは，GPAの気管支病変から広範に多発した肺囊胞による気胸を発症し，肺縫縮術および被覆術により治癒した症例を経験したので報告する．

A 42-year-old man had been treated for granulomatosis with polyangiitis for eight years. He was referred to our department with the diagnosis of right pneumothorax on chest radiograph. After chest drainage, the surgical treatment was performed because of continuing air leak from chest tube. Under thoracoscopic approach, the pleural adhesions were carefully dissected and the air leak site was sutured and enforced by a polyglycolic acid sheet with fibrin glue. No recurrence of pneumothorax was observed six months after surgery.