Wegener's granulomatosis: clinico-radiological finding at initial presentation.

Area of Science:

• Rheumatology
• Pulmonology
• Internal Medicine

Background:

• Wegener's granulomatosis (WG) diagnosis is often delayed by nonspecific symptoms mimicking other conditions.
• Understanding early clinical and radiological presentations is crucial for timely intervention.

Purpose of the Study:

• To describe the initial clinical and radiological features of Wegener's granulomatosis in a Serbian population.
• To analyze the frequency of organ involvement and diagnostic markers in this cohort.

Main Methods:

• Retrospective review of 37 Wegener's granulomatosis patient records from the Institute for Lung Diseases in Belgrade over 15 years.
• Analysis of patient demographics, symptom onset to diagnosis time, American College of Rheumatology criteria fulfillment, organ system involvement, and diagnostic test results (ANCA, ANA, histology).

Main Results:

• The study included 37 patients (20 males, 17 females; age 18-73). Mean diagnosis delay was 4.59 months.
• Generalized WG was present in 25 patients; 12 had limited respiratory involvement. 100% had lower respiratory tract involvement, 67.5% kidney, and 64.8% upper respiratory tract.
• Antineutrophil cytoplasmic antibodies (ANCA) were positive in 86.5% of patients. Histological evidence confirmed WG in 91.9%.

Conclusions:

• The clinical and radiological presentation of WG in the Serbian population aligns with international data, with a high prevalence of respiratory and kidney involvement.
• Early diagnosis remains a challenge, emphasizing the need for awareness of WG's diverse manifestations.
• ANCA positivity and histological findings are key diagnostic tools for Wegener's granulomatosis.