Case of Wegener's Granulomatosis

Wegener is a granulomatous necrotizing vasculitis characterized by a predilection to affect the upper and lower respiratory tracts and, in most cases, the kidneys. Case Report: Our case was a 20-year-old female with a history of common-cold like signs and symptoms in October 2007. At first, she was referred to a clinic of otolaryngology. By the clinical suspicion to sinusitis, she treated with co-amoxiclav; after 7 days, ear discharge was seen and with suspicion to acute otitis media the patient treated more. Despite of these problems, grippe and common-cold like symptoms was continued and then with suspicion to allergic rhinitis beclometason nasal spray and apo-citrizine tablet was started. In April 2008, she was complaining from knee, tarsal and hip arthralgia accompanied with maculopapular eruptions in distal of legs. In July 2008 sweating, weight loss and anemia was added to other problems and she referred to an oncology clinic and treated with blood infusion, vitamin B12, and folic acid. In October 2008, gastrointestinal symptoms including epigastric pain, hematemesis and vomiting added to other problems and she referred to a gastroenterologist and treated with pantoprazole and plasil. At last in December 2008, since the patient had arthritis of proximal interfalanges, hemoptesia, high ESR levels, and positive CRP, she referred to a rheumatologist and the patient sent to the Al-zahra hospital; after physical and laboratory examination, because of skin lesions, paranchymal lung disease, kidneys involvement, and presence of C-ANCA the diagnosis of Wegener was made and the patient treated with medical treatment.