[Wegener's granulomatosis with pronounced kidney involvement]

It is reported on the course of histologically ascertained Wegeners' granulomatosis in 4 patients. After initial affection of the upper respiratory tract in form of necrotizing and granulomatous inflammations in all cases a generalisation of the disease with above all early and severe participation of the kidneys developed. Maximum acceleration of sedimentation, C-reactive protein, anaemia, leucocytosis, eosinophilia, thrombocytosis, enlargement of the number of alpha 2-globulins, increase of creatinine, proteinuria, erythrocyturia and leucocyturia are the most frequent pathological laboratory findings, whereas LE-cells, ANF, rheumatoid factor and decrease of the complement never could be proved. By reason of a pathogenic immunoreaction a combined glucocorticoid therapy and immunosuppressive therapy with prednisolone and cyclophosphamide may favourably influence the course of the disease which is otherwise prognostically infaust.