Pulse methylprednisolone therapy in the treatment of Wegener's granulomatosis.

Five patients with Wegener's granulomatosis were treated with high-dose intravenous methylprednisolone (MTP) pulse therapy. Three out of five patients received MTP pulse therapy as the initial treatment and remission was achieved. Renal biopsy after the treatment confirmed the improvement of kidney involvement in 2 cases. Although the other two patients received MTP pulse therapy when a relapse occurred, the therapy could not suppress the progression of the disease. These observations suggest that MTP pulse therapy when given early may make it possible to suppress the progression of kidney involvement and improve the prognosis of the disease. Furthermore, it may also decrease the total doses of oral steroids and cyclophosphamide because of a strong anti-inflammatory and immunosuppressive action and consequently diminish the side effects. In conclusion MTP pulse therapy as the initial treatment may be beneficial in treating patients with Wegener's granulomatosis.