title: Wegener's granulomatosis presenting as multiple bilateral renal masses: case report and literature review.
abstract: Wegener's granulomatosis (WG) is a disease of unknown etiology characterized by necrotizing granulomatous vascularitis. The upper and lower respiratory tract and kidney involvements are very common; however, its presentation as bilateral renal masses is unusual. We report a case of a 59-year-old female patient who presented with multiple bilateral renal masses. The patient presented with sinusal and ocular symptoms suggestive of WG, and positive antineutrophil cytoplasmic antibodies (c-ANCA) with an anti-PR3 pattern. Histopathologic examination of the renal biopsy specimen revealed granulomatous inflammation with vasculitis and fibrinoid necrosis. The patient management, including prednisone and cyclophosphamid, induced a marked improvement of the renal masses. This case illustrates that WG should be considered in the differential diagnosis of renal masses.
authors.affiliation: Department of Internal Medicine, Hédi Chaker Hospital, Sfax, Tunisia. friguimakram@yahoo.fr
authors.forename: Makram
authors.initials: M
authors.lastname: Frigui
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ben Hmida
authors.forename: Manel
authors.initials: M
authors.lastname: Kechaou
authors.forename: Rachid
authors.initials: R
authors.lastname: Jlidi
authors.forename: Zouhir
authors.initials: Z
authors.lastname: Bahloul
mesh_terms: D019268:Antibodies, Antineutrophil Cytoplasmic; D001706:Biopsy; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D005123:Eye / Q000473:pathology; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis* / Q000473:pathology*; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology; D011859:Radiography; D014657:Vasculitis / Q000473:pathology*
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic