Abstract
IntroductionAccurate evaluation of disease status is very important in treatment of Wegener's granulomatosisCase presentationA 73-year-old Japanese man presented with chronic sinusitis and otitis media. He was admitted to our hospital because of bilateral lung nodules. Cytoplasmic antineutrophil cytoplasmic antibody was negative but his rheumatoid factor was high. He was diagnosed with limited Wegener's granulomatosis and received remission induction therapy. His serum rheumatoid factor level correlated with the Wegener's granulomatosis state when he experienced a severe infection and recurrence due to Wegener's granulomatosis.ConclusionWe describe a case of Wegener's granulomatosis in which rheumatoid factor was helpful for evaluating the therapeutic effect.
Highlights
Introduction: Accurate evaluation of disease status is very important in treatment of Wegener’s granulomatosis Case presentation: A 73-year-old Japanese man presented with chronic sinusitis and otitis media
We describe a case of cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) negative Wegener’s granulomatosis (WG) in which rheumatoid factor (RF) was useful for evaluating the disease status
Case presentation A 73-year-old Japanese man presented with a one year history of chronic sinusitis and otitis media that was unresponsive to otorhinolaryngological therapy
Summary
Wegener’s granulomatosis (WG) is a necrotizing granulomatous vasculitis with multisystem involvement. WG (limited disease) was diagnosed despite negative c-ANCA because our case met the American College of Rheumatology Diagnosis Criteria of 1990 for WG [1] He received remission induction therapy with prednisolone (PSL) 30 mg/day and trimethoprim-sulfamethoxazole (1:5) 960 mg/day, which improved his symptoms and laboratory test abnormalities. A CT scan revealed an increase in the size of the lung nodules and slight elevation in serum RF level, suggesting recurrence of WG, and the PSL was increased to 15 mg/ day. His fever abated and serum RF normalized
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