[Wegener's granulomatosis--diagnostic problem]

Wegener's granulomatosis there is a small--and middle--vessels vasculitis. The pathomorphological diagnostic criteria is known as Wegener's triad: 1) necrotizing granlomatous inflammation of upper and/or lower respiratory tract, 2) systemic or focal necrotizing vasculitis involving arteries and vein, and 3) focal segmental necrotizing crescentic gromerulonephritis. According to the current theory of pathogenesis of Wegener's granulomatosis, Staphylococcus aureus is involved. The rise in ANCA level during vascular inflammation is very important for monitoring disease. The main localization of Wagener's granulomatosis is in lung, nasal sinusites, nose, kidneys and nasal pharynx.

The history of 60-years old female patient who was being treated in Department of Otolaryngology for chronic bilateral otitis media for many years is presented. During hospitalization the sinusites, rhinitis and renal failure additionally were found. The CT sinuses and head, histopatological and ANCA exam in patient were performed.

Based on clinical, physical, additional exam Wegener's granulomatosis was diagnosed.

1) Surgical procedure is not indicated method of treatment of Wegener's granulomatosis, because it can increase the pathologic process. 2) The prognosis of Wegener's granulomatosis depends mainly on the ability to diagnose the early disease and the aplication of adequate treatment.