1. Wegener's granulomatosis triggered by infection?
- Author
-
Boudewyns A, Verbelen J, Koekelkoren E, Van Offel J, and Van de Heyning P
- Subjects
- Acute Disease, Antibodies, Antineutrophil Cytoplasmic blood, Biopsy, Fatigue microbiology, Fever microbiology, Granulomatosis with Polyangiitis blood, Granulomatosis with Polyangiitis immunology, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Rhinitis microbiology, Sinusitis microbiology, Staphylococcal Infections diagnosis, Suppuration, Tomography, X-Ray Computed, Weight Loss, Carrier State diagnosis, Granulomatosis with Polyangiitis diagnosis, Granulomatosis with Polyangiitis microbiology, Nasal Mucosa microbiology, Staphylococcal Infections complications
- Abstract
Wegener's granulomatosis is a systemic disease of unknown origin, although recent studies suggest that auto-immune mechanisms and infection play a role in the pathogenesis of this disease. Wegener is characterized by a necrotizing vasculitis involving the lungs (pulmonary infiltrates), the upper airways and the kidneys (rapidly progressive glomerulonephritis). We present a case of a male patient admitted because of progressive deterioration of the general condition with weight loss, a unilateral neck mass, unilateral purulent rhinorrea and fever. CT-scan evaluation demonstrated a unilateral expanding mass in the sing-nasal cavity, obliterating the ethmoid complex. MRI revealed signs of intracranial inflammatory reaction and onset of absedation. A malignancy was suspected but a diagnosis of Wegener's granulomatosis was established based on histologic criteria (nasal biopsy) and a positive titer for anti-cytoplasmic antibodies (cANCA). During follow-up, nasal carriage of Staphyloccocus Aureus could be documented. An overview of Wegener's granulomatosis will be provided with emphasis on the potential role of acute infections as a trigger for Wegener's granulomatosis and the head and neck manifestations.
- Published
- 2001