Early diagnosis and stage-adapted treatment of Wegener's granulomatosis.
A case of Wegener's granulomatosis (WG) presenting with hearing loss and right facial nerve palsy is reported. The definitive diagnosis was based upon clinical data and serum cANCA and AECA detection. Early assessment of WG prevented surgical facial nerve decompression to treat a chronic otitis media complication. Immunosuppressive therapy with steroids, cyclophosphamide and methotrexate was required for relief of clinical symptoms and cANCA negativity as an expression of disease remission. The effectiveness of co-trimoxazole for preventing relapses of WG is discussed.
Cadoni
G
G
Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome, Italy. gabcad@virgilio.it
Agostino
S
S
Campobasso
E
E
Vulpiani
P
P
Manna
R
R
Galli
J
J
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004433:Earache / Q000209:etiology; D005158:Facial Paralysis / Q000209:etiology; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006312:Hearing Loss, Bilateral / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D008775:Methylprednisolone; D008727:Methotrexate