title: A case of granulomatosis with polyangiitis (Wegener's granulomatosis) presenting with marked inflamed tracheobronchial mucosa.
abstract: A 70-year-old man was admitted to our hospital because of weight loss and persistent dry cough. Chest radiograph and CT showed multiple infiltrates in the bilateral upper lobes and the remarkably thickened bronchial walls. Bronchoscopy revealed diffuse erythema and edema of the tracheobronchial mucosa without any ulcerous legions. Serum MPO-ANCA was positive (155 EU). Transbronchial biopsy was performed and revealed necrotic granulomas with multinucleated giant cells in the bronchial/bronchiolar and parenchymal lesions. Thus, we diagnosed it as a localized form of granulomatosis with polyangiitis (GPA, Wegener's granulomatosis). After treatment with corticosteroid and cyclophosphamide, the bronchial findings were entirely resolved. We report here a rare case of GPA presenting with markedly inflamed tracheobronchial mucosa.
authors.affiliation: Department of Respiratory Medicine, Akashi Medical Center, 743-33 Yagi, Okubo-cho, Akashi, Hyogo 674-0063, Japan ; Department of Respiratory Medicine, Kakogawa West City Hospital, 384-1 Hiratsu, Yoneda-cho, Kakogawa, Hyogo 675-8611, Japan.
authors.forename: Teruaki
authors.initials: T
authors.lastname: Nishiuma
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Sho
authors.initials: S
authors.lastname: Yoshimura
authors.forename: Saori
authors.initials: S
authors.lastname: Kinami
authors.forename: Susumu
authors.initials: S
authors.lastname: Sakamoto