Aneurysmal subarachnoid hemorrhage in a patient with Wegener's granulomatosis.
A 34-year-old Japanese man admitted to hospital with pneumonia had previously undergone surgery for paranasal sinusitis and also for the clipping of an aneurysm at the origin of the anterior choroidal artery after subarachnoid hemorrhage. Laboratory tests performed at the present admission showed renal insufficiency and serological findings of raised proteinase 3 antineutrophil cytoplasmic antibody level. A renal biopsy was performed that showed diffuse necrotizing glomerulonephritis with fibrocellular crescents. The diagnosis of Wegener's granulomatosis(WG) was confirmed on the basis of the clinical picture, laboratory findings, and biopsies of renal tissues. The disease responded to prednisolone and cyclophosphamide. The association of WG with a ruptured intracranial aneurysm is rare and has not previously been confirmed.
Takei
Hiroyuki
H
Second Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-0022, Japan. h-takei@sc4.so-net.ne.jp.
Komaba
Yuichi
Y
Kitamura
Hiroshi
H
Hayama
Noriaki
N
Osawa
Hirokazu
H
Furukawa
Tetsuya
T
Hasegawa
Osamu
O
Iino
Yasuhiko
Y
Katayama
Yasuo
Y
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002533:Cerebral Angiography; D003520:Cyclophosphamide / Q000627:therapeutic use; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D015508:Nasal Obstruction / Q000601:surgery; D011500:Protein Synthesis Inhibitors / Q000627:therapeutic use; D012852:Sinusitis / Q000601:surgery; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D014057:Tomography, X-Ray Computed
D000893:Anti-Inflammatory Agents; D011500:Protein Synthesis Inhibitors; D003520:Cyclophosphamide; D008775:Methylprednisolone