Clinical Experiences of Diagnosis and Treatment for Wegener's Granulomatosis.
- Author:
Kyung Tae PARK
1
;
Il Gyu KONG
;
Doo Hee HAN
;
Dae Woo KIM
;
Si Hwan KIM
;
Chae Seo RHEE
;
Chul Hee LEE
;
Yang Gi MIN
;
Dong Young KIM
Author Information
1. Department of Otorhinolaryngology, College of Medicine and Research Center for Sensory Organs, Medical Research Center, Seoul National University, Seoul, Korea. dongkim@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Wegener granulomatosis;
Diagnosis;
ANCA;
Biopsy
- MeSH:
Antibodies, Antineutrophil Cytoplasmic;
Biopsy;
Cyclophosphamide;
Dyspnea;
Early Diagnosis;
Female;
Follow-Up Studies;
Head;
Hearing Loss;
Hoarseness;
Humans;
Joints;
Kidney;
Lung;
Male;
Medical Records;
Nasal Obstruction;
Neck;
Prednisolone;
Retrospective Studies;
Skin;
Wegener Granulomatosis
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
2008;51(12):1109-1118
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Because most patients with Wegener's granulomatosis (WG) visit otolaryngologists complaining of head and neck symptoms, otolaryngologists may play an important role in early diagnosis. In this study, we investigated clinical features, laboratory findings and treatment outcomes of 33 patients with WG, and propose a new algorithm for the diagnosis of WG. SUBJECTS AND METHOD: Thirty-three patients with WG who visited the clinic between January 1980 and December 2007 were included. The medical records of 13 male and 20 female patients were retrospectively reviewed. The mean follow-up duration was 68 months. RESULTS: Most WG patients had ENT symptoms such as nasal obstruction, rhinorrhea, otorrhea, hearing loss, dyspnea and hoarseness. The mean duration from ENT examination to diagnosis was 6.7 months (3 days- 102 months) and tissue biopsy was performed on an average of 2.1 times to confirm the diagnosis. While 16 patients could be diagnosed by the first biopsy, the others were required to repeat the biopsy. ANCA was positive in 17 patients (50%). Twentysix patients (78.7%) had multiple organ involvements such as lung, kidney, joint and skin. Twenty-eight patients received a combination of prednisolone and cyclophosphamide with the remission rate of 87%. CONCLUSION: Based on this study, we propose a better algorithm for the diagnosis of WG to avoid unnecessary delay in the diagnosis and treatment of WG.
