Recurrent Wegener's granulomatosis with subglottic granulation.
While following the course of patients with Wegener's granulomatosis (WG) in which it had been possible to achieve a remission, we encountered a patient in whom we observed granuloma formation in the subglottis. A tracheotomy was performed because of the risk of respiratory distress, and after that there was a recrudescence of the patient's WG. During the course of the above, the patient remained cANCA (anti-neutrophil cytoplasmis antibody with cytoplasmic pattern)-negative. When these facts were considered, it appeared that when the lesions are localized and progressing gradually, cANCA positivity does not develop. While cANCA test has gradually become a powerful tool for the diagnosis of WG, a comprehensive physical examination to identify localized lesions, together with biopsy and histopathological examination, should allow the diagnosis of WG.
Okamura
H
H
Department of Anatomy II, Fukushima Medical University School of Medicine, Japan.
Anzai
T
T
Misawa
T
T
D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis; D005931:Glottis / Q000473:pathology*; D006099:Granuloma / Q000473:pathology*; D014890:Granulomatosis with Polyangiitis / Q000473:pathology*; D006801:Humans; D008297:Male; D012008:Recurrence
D019268:Antibodies, Antineutrophil Cytoplasmic