[The diagnostic problem of Wegener's granulomatosis (author's transl)]

Histological findings of granulomatous vasculitis can frequently be absent in attempting to diagnose early nasal manifestations of Wegener's granulomatosis. In such cases, one has to rely on clinical findings and laboratory data (particularly an excessively high blood sedimentation rate). The possibility for misdiagnosis is illustrated in four patients who all appeared to have Wegener's granulomatosis. Followup over many months revealed that the diagnosis was correct in only two of the patients, indicating also the problems associated with inappropriate treatment.