A Case of Nontuberculous Mycobacteria Infection That Was Misdiagnosed as an Invasion of Wegener's Granulomatosis / 대한류마티스학회지

Wegener's granulomatosis is a rare disease that pathologically causes necrotizing granulomatous vasculitis in the arterioles and venules and it can invade the whole body. In addition, it is difficult to distinguish between a nontuberculous mycobacteria infection that shows manifestations of granuloma and Wegener's granulomatosis. There has been no reported on a patient who had the 2 abovementioned two diseases at the same time. A 69 year old male patient had Wegener's granulomatosis that had invaded the prostate. He also had a scrotal swelling and back pain. He had manifestations of granulomatous infection on the scrotum and spine biopsies. However, there was no clinical evidence of Wegener's granulomatosis. As a result, we examined him for other diseases that can cause a granuloma. Consequently, he was also diagnosed as suffering with a nontuberculous mycobacteria infection. We report here on this case and we review the relevant medical literature.

Long-Term Prognosis and Clinical Characteristics of Patients With Variant Angina

BACKGROUND AND OBJECTIVES: The overall prognosis of patients with vasospastic angina (VA) is relatively good. However, the long-term prognosis and its influencing factors are not well understood in Korean patients. SUBJECTS AND METHODS: Between August 1996 and January 2007, 256 consecutive patients with VA were reviewed (215 men, 53+/-9 years). Coronary spasm was confirmed via intravenous ergonovine provocation in all study patients during coronary angiography. Major adverse cardiac events (MACEs) were defined as myocardial infarction (MI), resuscitation from cardiac arrest, or repeat hospitalization due to recurrent angina. RESULTS: The 256 patients were followed for an average of 59 months (range, 5 months to 11 years). Thirty-one patients (12.1%) were lost to follow-up. Cardiac deaths occurred in 6 patients (2.3%), non-fatal MIs occurred in 3 patients (1.2%), and MACEs occurred in 52 patients (20.3%). The rates of survival at 1, 3, and 5 years were 99%, 97%, and 97%, respectively, and the rates of MI-free survival at 1, 3, and 5 years were 99%, 96%, and 95%, respectively. Rates of MACE-free survival at 1, 3, and 5 years were 91%, 81%, and 62%, respectively. MI at initial presentation and current smoking were factors significantly associated with MACEs; these factors were also independent predictors of MACE-free survival. CONCLUSION: Despite treatment with calcium channel blockers, recurrent episodes of angina were frequently observed, whereas sudden cardiac death and non-fatal MI were rare. Smoking and myocardial infarction at admission were independent risk factors for cardiac death, non-fatal MI, and repeat hospitalization due to recurrent angina in patients with variant angina.