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Wegener granulomatosis revealed by pleural effusion.
Anne-Claire Toffart1, François Arbib, Sylvie Lantuejoul
1Clinique de Pneumologie, Pôle Médecine Aiguë Communautaire, Centre Hospitalier Universitaire Albert Michallon, 38043 Grenoble cedex 09, France.
Case Reports in Medicine
|February 20, 2010
Summary
Wegener's granulomatosis (WG) can present with pleural effusion, a rare initial symptom. This case highlights the importance of considering WG in patients with unexplained pleural effusion and vasculitis.
Area of Science:
- Medicine
- Rheumatology
- Pulmonology
Background:
- Pulmonary manifestations are frequent in Wegener's granulomatosis (WG).
- Pleural effusion as an initial presentation of WG is exceptionally rare.
- Early diagnosis and treatment are crucial for managing WG.
Observation:
- A 45-year-old male presented with dorsal pain, pleural thickening, and effusion.
- Thoracic imaging revealed a nodule, and biopsies showed chronic inflammation and necrotizing granulomatous vasculitis.
- Serological tests were positive for antineutrophil cytoplasmic antibodies (ANCA) and antiproteinase 3 (PR3) antibodies.
Findings:
- The patient was diagnosed with Wegener's granulomatosis based on clinical, pathological, and serological findings.
- Initial treatment with cyclophosphamide and methylprednisolone resulted in a favorable clinical evolution.
- This case underscores the diagnostic challenge of WG presenting with pleural effusion.
Implications:
- Pleural effusion should be considered in the differential diagnosis of Wegener's granulomatosis.
- Recognizing rare initial presentations of WG can lead to timely intervention.
- Further research into the diverse clinical spectrum of WG is warranted.
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