title: Wegener granulomatosis revealed by pleural effusion.
abstract: Pulmonary signs are common in Wegener's granulomatosis (WG). However, an initial presentation including pleural effusion has not been described. We describe a case of WG in which pleural effusion was the first clinical manifestation. A 45-year-old man with dorsal pain presented with pleural thickening and effusion, and a visible nodule on a thoracic scan. A dense chronic inflammatory infiltrate was obtained by pleural biopsy and an open lung biopsy revealed necrotizing granulomatous vasculitis. Serologies were positive for antineutrophil cytoplasmic antibodies and antiproteinase 3 antibodies. A diagnosis of WG was conducted and the patient was started on cyclophosphamide and methylprednisolone as an initial treatment, with a favorable evolution. Although pleural effusion is rarely described in WG, this pathology must be considered in the presence of this clinical manifestation.
authors.affiliation: Clinique de Pneumologie, Pôle Médecine Aiguë Communautaire, Centre Hospitalier Universitaire Albert Michallon, 38043 Grenoble cedex 09, France.
authors.forename: Anne-Claire
authors.initials: AC
authors.lastname: Toffart
authors.forename: François
authors.initials: F
authors.lastname: Arbib
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lantuejoul
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Roux
authors.forename: Vincent
authors.initials: V
authors.lastname: Bland
authors.forename: Gilbert
authors.initials: G
authors.lastname: Ferretti
authors.forename: Samia
authors.initials: S
authors.lastname: Diab