[Specific gastric localization of Wegener's disease]

We report an unusual gastric ulcer disease in a 52 year old white man which relapsed despite antacids and anti-H2 treatment. During the course of the disease, fever, weight loss, and ocular, oropharyngeal as well as systemic manifestations occurred. Gastric biopsies were normal until macrobiopsy was performed 5 months later demonstrating necrotizing granulomatous vasculitis. Further identical oropharyngeal mucosal lesions and a pulmonary infiltrate occurred supporting the diagnosis of Wegener's disease. The subsequent course was complicated by a massive hemorrhage which required total gastrectomy. Despite specific treatment with cyclophosphamide and steroids, the patient died. Most of the gastrointestinal lesions consistent with Wegener's disease are usually found at necropsy. Clinical gastrointestinal manifestations are scarce and rarely due to the underlying disease. Prognosis depends upon the renal lesions. However, as well, involvement of the digestive tract seems to be a factor of poor evolution of the disease.