Wegener's Granulomatosis: Are We Still Missing It?

Area of Science:

• Internal Medicine
• Rheumatology
• Pulmonology

Background:

• Wegener's granulomatosis is a rare autoimmune disease causing inflammation of blood vessels.
• Pulmonary tuberculosis is a common infectious disease often considered in patients with lung symptoms.

Observation:

• An 18-year-old female presented with worsening respiratory symptoms and superficial vein thrombosis.
• Initial diagnosis was smear-negative pulmonary tuberculosis, leading to antituberculosis treatment.

Findings:

• Diagnosis was confirmed as Wegener's granulomatosis via cytoplasmic anti-neutrophil cytoplasmic antibody testing and lung biopsy.
• The patient experienced clinio-radiological worsening and superficial vein thrombosis.

Implications:

• This case underscores the importance of considering autoimmune diseases like Wegener's granulomatosis in differential diagnoses.
• Early and accurate diagnosis is crucial to prevent complications and ensure appropriate treatment for Wegener's granulomatosis.
• The association of superficial vein thrombosis with pulmonary manifestations in Wegener's granulomatosis is rare and warrants clinical attention.