title: Massive pleural effusion and bronchopleural fistula in Wegener's granulomatosis.
abstract: Wegener's granulomatosis (WG) is characterized by systemic granulomatous necrotizing vasculitis, primarily affecting the respiratory tract and kidneys. We describe a rare case in a 28-year-old woman with WG, presenting with a massive lateral pleural effusion, accompanied by an aseptic bronchopleural fistula formed during immunosuppressive treatment. Although any organ can be involved in WG, only left pleuritis and a purpuric lesion on the neck were detected in this case. The pleural effusion and bronchopleural fistula resolved following immunosuppressive treatment for six months. Thus, WG should be considered in the differential diagnosis of a massive pleural effusion, and fistula formation is a possible complication of treatment. Moreover, immunosuppressive treatment was sufficient to resolve the massive pleural effusion and fistula formation without infection (120 words).
authors.affiliation: Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Koyama
authors.forename: K
authors.initials: K
authors.lastname: Murakami
authors.forename: T
authors.initials: T
authors.lastname: Sakakibara
authors.forename: S
authors.initials: S
authors.lastname: Muramatsu
authors.forename: M
authors.initials: M
authors.lastname: Watanabe
authors.forename: M
authors.initials: M
authors.lastname: Miki
authors.forename: M
authors.initials: M
authors.lastname: Ebina
authors.forename: T
authors.initials: T
authors.lastname: Nukiwa
mesh_terms: D000328:Adult; D001706:Biopsy; D001983:Bronchial Fistula / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D010995:Pleural Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D010996:Pleural Effusion / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D049268:Positron-Emission Tomography; D016156:Respiratory Tract Fistula / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012867:Skin / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents