Wegener's granulomatosis: Possible role of environmental agents in its pathogenesis.
OBJECTIVE
To investigate the possibility that environmental agents contribute to the pathogenesis of Wegener's granulomatosis (WG).


METHODS
We undertook an extensive search for possible environmental exposures by developing a comprehensive questionnaire that was administered by telephone interview to 53 patients with WG and 2 control groups: one with osteoarthritis and the other with gout. Questions focused on hobbies and vocations, work, home, and allergies. Exact logistic regression was used to calculate odds ratios and 95% confidence intervals after adjusting for potential confounders. After adjusting for age and sex, data are reported for all exposures with odds ratios >2.0 against either control group or for any allergic propensity.


RESULTS
Results suggest that mercury and perhaps lead exposure were positively associated with WG as compared with either control group, although the number of patients exposed was small. A prior history of allergy was also associated with WG as compared with either control group.


CONCLUSIONS
We conclude that heavy metal exposure and a prior history of allergy may play a role in the etiopathogenesis of Wegener's granulomatosis.
Albert
Daniel
D
University of Pennsylvania, Philadelphia 19104, USA. albertd@mail.upenn.edu
Clarkin
Cheryl
C
Komoroski
Jodi
J
Brensinger
Colleen M
CM
Berlin
Jesse A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002248:Carbon Monoxide / Q000009:adverse effects; D004651:Employment; D004781:Environmental Exposure; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000209:etiology*; D015386:Hazardous Substances / Q000009:adverse effects*; D006686:Hobbies; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology; D007854:Lead / Q000009:adverse effects*; D008297:Male; D008628:Mercury / Q000009:adverse effects*; D008875:Middle Aged; D011407:Propane / Q000009:adverse effects / Q000031:analogs & derivatives*; D011795:Surveys and Questionnaires
D015386:Hazardous Substances; D007854:Lead; D002248:Carbon Monoxide; C007318:1,2-dibromo-3-chloropropane; D008628:Mercury; D011407:Propane