title: [Unusual presentation of Wegener's granulomatosis].
abstract: We report an unusual case of Wegener's granulomatosis revealed by spleen infarction and complicated by reno-vascular hypertension. A 33-year-old man with a history of spleen infraction and cerebral venous thrombosis was admitted for malignant hypertension, renal failure and nephritic syndrome. On Doppler renal ultrasonography, ostial stenosis of the right renal artery was evidenced. Right kidney was non functional on scintigraphy and the patient underwent a right nephrectomy. Granulomatous vasculitis of the right renal artery was found but anti-neutrophilic cytoplasmic antibodies were absent. The diagnosis of Wegener's granulomatosis was suspected. The patient was treated with cyclophosphamide, corticosteroids and plasma exchanges, and renal function markedly improved.
authors.affiliation: Service de médecine interne, hôpital Habib-Thameur, 8, rue Ali-Ben-Ayed, Montfleury, 1008 Tunis, Tunisia. sktari@mailcity.com
authors.forename: S Ketari
authors.initials: SK
authors.lastname: Jamoussi
authors.forename: B
authors.initials: B
authors.lastname: Ben Dhaou
authors.forename: F
authors.initials: F
authors.lastname: Boussema
authors.forename: E
authors.initials: E
authors.lastname: Turki
authors.forename: S
authors.initials: S
authors.lastname: Kochbati
authors.forename: O
authors.initials: O
authors.lastname: Cherif
authors.forename: M
authors.initials: M
authors.lastname: Maamar
authors.forename: L
authors.initials: L
authors.lastname: Rokbani
mesh_terms: D000328:Adult; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology; D020767:Intracranial Thrombosis / Q000209:etiology; D008297:Male; D013159:Splenic Infarction / Q000209:etiology