Wegener肉芽腫症と鼻悪性細網症の治療

WEGENER'S GRANULOMA AND NASAL RETICULOSARCOMA

　I．はじめに

　鼻腔を含む上気道の壊死性肉芽性疾患は，発熱・全身倦怠感・赤沈値の亢進など，炎症症状，所見が前面にでてくることが少なくない^1）〜3）。

　この場合，局所の生検組織は単なる炎症性肉芽としか診断されないことが多い^3）4）。しかし，この中には，違つた治療を必要とする2つの疾患群が含まれている^{1）5）〜7）}。

　The differential diagnosis of Wegener's granuloma and that of the nasal reticuloarcomatosis, both involving the upper air passage, is quite difficult. But, the treatment for each should be different.

　The etiology in both diseases is unknown, consequently specific treatment for either is, also, in the dark. With use of corticosteroids and immunosuppressive agents the treatment of Wegener's granuloma appears to be quite effective. However, during the active stage of the disease, the effect of immunosuppressive agents appears to be indirect and the use of corticosteroids seems to be more effective.

　On the other hand, in nasal reticulosarcoma the lesion appears to be sarcomatous rather than being immunologic abnormality or inflammatory in origin, the treatment of this condition seems to be more effective by use of immunosuppressive agents combined with radiotherapy.