[Involvement of lacrimal organs in Wegener's granulomatosis]

Wegener's granulomatosis (WG) is a primary systemic vasculitis characterized by the development of granulomatous inflammation and necrotizing vasculitis of small- and middle-sized vessels. The clinical symptoms of the involvement of lacrimal organs in WG are of no specificity. Lacrimal tract lesion is encountered in prolonged Wegener's granulomatosis. Whether surgical intervention can and should be made in these patients remains to be debated. Successful surgical treatment for chronic dacryocystitis with recurrent lacrimal sac phlegmon in a female patient with WG has been used as an example to show that endoscopic endonasal dacryocystorhinostomy is the most sparing surgical treatment of dacryocystitis and therefore it is preferable in WG patients and effective at remission during systemic therapy with additional doses of corticosteroids in the pre- and postoperative periods. Lacrimal gland involvement (more commonly diffuse infiltration) is observed at the early stages of the disease and may be the first manifestation of WG so the latter should be excluded when long-term therapy for chronic dacryoadenitis fails.