Generalized Wegener's granulomatosis responding to sulfamethoxazole-trimethoprim monotherapy.
Wegener's granulomatosis (WG) has two different clinical phases: the initial phase and generalized phase. In patients with generalized WG, both steroids and cyclophosphamide have generally been used. We report a case of generalized WG that was temporarily, but successfully treated with sulfamethoxazole-trimethoprim (S/T) alone. S/T therapy reduced the elevated levels of soluble IL-2 receptor and IL-6 in parallel with improvement of the patient's symptoms and urinary protein excretion. In view of the high incidence of lethal adverse effects of cytotoxic drugs, S/T monotherapy may be worth trying not only for initial phase WG but also for generalized WG with careful follow-up when the patient is not acutely ill.
Ohtake
T
T
Department of Medicine, Fujinomiya City General Hospital, Fujinomiya.
Kobayashi
S
S
Honjou
Y
Y
Shirai
T
T
Takayanagi
S
S
Tohyama
K
K
Tokura
Y
Y
Kimura
M
M
D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D016207:Cytokines / Q000097:blood; D004338:Drug Combinations; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D012074:Remission Induction; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
D000890:Anti-Infective Agents; D016207:Cytokines; D004338:Drug Combinations; D015662:Trimethoprim, Sulfamethoxazole Drug Combination