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Misleading clinical features in Wegener's granulomatosis. A case report

Published online by Cambridge University Press:  29 June 2007

Giovanni Almadori*
Affiliation:
Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome.
Maurizio Trivelli
Affiliation:
Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome.
Emanuele Scarano
Affiliation:
Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome.
Gabriella Cadoni
Affiliation:
Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome.
*
Address for correspondence: Giovanni Almadori, M.D., Largo Agostino Gemelli, 8, 00168 – Rome, Italy Fax: 39.6.3051343-194

Abstract

Wegener's granulomatosis is a systemic vasculitis that may present with a Variety of findings and be difficult to diagnose. We report a case of a patient who presented with serous otitis media and subsequently developed a suspected primary lung tumour. Thoracotomy and pulmonary mass excision were required to establish the diagnosis. Otological manifestations of Wegener's granulomatosis, differential diagnosis, pathological findings and c-ANCA test role are discussed.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1997

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References

Anderson, G., Coles, E. T., Crane, M., Douglas, A. C., Gibbs, A. R., Geddes, D. M., Peel, E. T., Wood, J. B. (1992) Wegener's granuloma. A series of 265 British cases seen between 1975 and 1985. A report by a sub-committee of the British Thoracic Society Research Committee. Quarterly Journal of Medicine 302: 427438.Google Scholar
Benson-Mitchell, R., Tolley, N., Croft, C. B., Roberts, D. (1994) Wegener's granuloma presenting as a unilateral parotid swelling. Journal of Laryngology and Otology 108: 431432.CrossRefGoogle ScholarPubMed
Carrie, S., Hughes, K. B., Watson, M. G. (1994) Negative ANCA in Wegener's granulomatosis. Journal of Laryngology and Otology 108: 420422.CrossRefGoogle ScholarPubMed
Choufani, G., Hassid, S., Hennebert, D. (1991) Granulomatose de Wegener a revelation otologique. Acta Oto-rhinolaryngologica Belgica 45: 375479.Google Scholar
Cohen Tervaert, J. W., Huitema, M. G., Henè, R. J., Sluiter, W. J., The, T. H., van der Hem, G. K., Kallenberg, C. G. (1990) Prevention of relapses in Wegener's granulomatosis by treatment based on anti-neutrophil cytoplasmic antibody titre. Lancet 336: 709711.CrossRefGoogle Scholar
Davenport, A. (1992) ‘False positive’ perinuclear and cytoplasmic anti-neutrophil cytoplasmic antibody results leading to misdiagnosis of Wegener's granulomatosis and/or microscopic polyarteritis. Clinical Nephrology 37: 124130.Google ScholarPubMed
Fauci, A. S., Haynes, B. F., Katz, P., Wolff, S. M. (1983) Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. Annals of Internal Medicine 98: 7685.CrossRefGoogle ScholarPubMed
Gordon, C., Luqmani, R., Fields, P., Howie, A. J., Emery, P. (1993) Two cases of ‘Wegener's Tuberculosis’. British Journal of Rheumatology 32: 143149.CrossRefGoogle ScholarPubMed
Illum, P., Thorling, K. (1981) Wegener's granulomatosis longterm results of treatment. Annals of Otology, Rhinology and Laryngology 90: 231234.CrossRefGoogle ScholarPubMed
Kallenberg, C. G. M., Mulder, A. H. L., Cohen Tervaert, J. W. (1992) Antineutrophil cytoplasmic antibodies: A still-growing class of autoantibodies in inflammatory disorders. American Journal of Medicine 93: 675681.CrossRefGoogle ScholarPubMed
Kornblut, A. D., Wolff, S. M., deFries, H. O., Fauci, A. S. (1982) Wegener's granulomatosis. Otolaryngologic Clinics of North America 15: 673683.CrossRefGoogle ScholarPubMed
Lebovics, R. S., Hoffman, G. S., Leavitt, R. Y., Kerr, G. S., Travis, W. D., Kammerer, W., Hallahan, C., Rottem, M., Fauci, A. S. (1992) The management of subglottic stenosis in patients with Wegener's granulomatosis. Laryngoscope 102: 13411345.CrossRefGoogle ScholarPubMed
Lee, S. J., Berry, G. J., Husari, A. W. (1993) Wegener's granulomatosis presenting as right middle lobe obstruction. Chest 103: 16231624.CrossRefGoogle ScholarPubMed
Macias, J. D., Wackym, P. A., McCabe, B. F. (1993) Early diagnosis of otologic Wegener's granulomatosis using the serologic marker c-ANCA. Annals of Otology, Rhinology and Laryngology 102: 337341.CrossRefGoogle ScholarPubMed
Wegener, F. (1990) Wegener's granulomatosis. Thoughts and observations of a pathologist. European Archives of Oto-Rhino-Laryngology 247: 133142.CrossRefGoogle ScholarPubMed