title: [A case of refractory Wegener's granulomatosis successfully treated with high-dose methotrexate].
abstract: We report a case of generalized Wegener's granulomatosis (WG) successfully treated with high-dose methotrexate (MTX) and predonisolone (PSL). A 35 year-old men had complaints of auditory disturbance and nasal hemorrhage. Diagnosis of WG was made based on positive proteinase-3 anti-neutrophil cytoplasmic antibody (PR3-ANCA), lung nodules, and focal necrotizing glomerulonephritis revealed by renal biopsy. Treatment with cyclophosphamide (CY) and PSL for 3 months was ineffective for the lung nodules. Then, CY was changed to high dose MTX (18mg/week), and his lung lesions improved. In Japan, it is unusual to treat WG with high-dose MTX, but this treatment may be useful in CY-resistant WG.
authors.affiliation: Division of Respiratory Medicine.
authors.forename: Takashi
authors.initials: T
authors.lastname: Shimizu
authors.forename: Natsue
authors.initials: N
authors.lastname: Shimizu
authors.forename: Toshinori
authors.initials: T
authors.lastname: Takada
authors.forename: Fumitake
authors.initials: F
authors.lastname: Gejyo
authors.forename: Takashi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Eiichi
authors.initials: E
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D003520:Cyclophosphamide / Q000494:pharmacology; D004334:Drug Administration Schedule; D004351:Drug Resistance; D014890:Granulomatosis with Polyangiitis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage*; D011239:Prednisolone / Q000008:administration & dosage; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone; D008727:Methotrexate