Accute Wegener’s Granulomatosis

Abstract

Wegener's granulomatous is distinct Clinico-pathological entity characterized bysystemic vasculitis and necrotizing granulomatous inflammation. It is a multi systemic disease mainly involving upper and lower respiratory tracts and kidneys. We present a case of 36-year old male patient admitted with complaints of headache, muco purulent blood stained nasal dischargeassociated with low grade fever, cough and haemoptysis. Initially he was treated on the lines of sinusitis with necrotizing pneumonia. The chest X-ray revealed multiple cavitatory lesions in both lung fields. He had high levels of serum anti neutrophilic cytoplasmic antibody (C-ANCA). His nasal biopsy revealed granulomatous inflammatory response. Based on these findings, diagnosis of Wegener’s Granulomatosis was made and combined therapy of steroids and cyclophosphamide started. He couldn’t tolerate cyclophosphamide and was switched to Azathioprine. The patient showed dramatic improvement and recovered clinically and radiologically.