Radiographic course of pulmonary manifestations in Wegener's granulomatosis under immunosuppressive therapy.
Eleven patients with generalized Wegener's granulomatosis were studied. Pulmonary involvement occurred 1 month earlier than a rapid rise of serum creatinine value. Under immunosuppressive therapy, nodules and infiltrations abated slower in patients with bronchopulmonary superinfection (mean, 30 days) compared with patients without superinfection (mean, 18 days). In the short run, radiographic course was a better indicator for therapeutic success than the course of cytoplasmatic antineutrophil cytoplasm antibody titer. If the pulmonary findings did not begin to clear within 1 week after treatment had been started, either superinfection or insufficient immunosuppression was present. In this situation, a more aggressive therapy in combination with antibiotics is suggested.
Grotz
W
W
Department of Medicine, University of Freiburg, Germany.
Mundinger
A
A
Würtemberger
G
G
Peter
H H
HH
Schollmeyer
P
P
D000328:Adult; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies / Q000097:blood; D001424:Bacterial Infections / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D013902:Radiography, Thoracic; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D019268:Antibodies, Antineutrophil Cytoplasmic; D001323:Autoantibodies; D015415:Biomarkers; D007074:Immunoglobulin G; D003520:Cyclophosphamide; D003404:Creatinine; D011241:Prednisone