DIAGNOSES AND DISCUSSION OF CHALLENGING CLINICAL CASE NO. 02/2001
Wegener’s granulomatosis
| A variety of diseases involve both pulmonary and rental (and, often, also dermal) microvasculature and may present with either prominent pulmonary or rental manifestations. When a firm diagnosis cannot be made serologically or by biopsy of skin or upper respiratory – tract lesion, rental biopsy may be necessary. In the case described in the question, the serologic findings, though not specific, are typical of Wegener’s granulomatosis, a diagnosis established by the rental biopsy report. Granulomas are an uncommon microscopic finding in polyateritis as well as in lupus nephritis and in Henoch – Schonlein purura, though a spectrum of pathological abnormalities may be seen in the latter two conditions. The rental biopsy in Goodpasture’s syndrome usually reveals liner immunoglobulin desposits. |