Frigui Makram, Ben Hmida Mohamed, Kechaou Manel, Jlidi Rachid, Bahloul Zouhir
Department of Internal Medicine, Hédi Chaker Hospital, Sfax, Tunisia.
Rheumatol Int. 2009 Apr;29(6):679-83. doi: 10.1007/s00296-008-0715-4. Epub 2008 Sep 25.
Wegener's granulomatosis (WG) is a disease of unknown etiology characterized by necrotizing granulomatous vascularitis. The upper and lower respiratory tract and kidney involvements are very common; however, its presentation as bilateral renal masses is unusual. We report a case of a 59-year-old female patient who presented with multiple bilateral renal masses. The patient presented with sinusal and ocular symptoms suggestive of WG, and positive antineutrophil cytoplasmic antibodies (c-ANCA) with an anti-PR3 pattern. Histopathologic examination of the renal biopsy specimen revealed granulomatous inflammation with vasculitis and fibrinoid necrosis. The patient management, including prednisone and cyclophosphamid, induced a marked improvement of the renal masses. This case illustrates that WG should be considered in the differential diagnosis of renal masses.
