Wegener's granulomatosis presenting as a pleural effusion

摘要

Wegener's granulomatosis is one of the pauci-immune small vessel vasculitides. It classically presents with the triad of upper and lower respiratory tract granulomas and necrotising focal segmental glomerulonephritis. It is associated with the presence in the serum of autoantibodies against components of neutrophil cytoplasm―antineutrophil cytoplasmic autoantibodies (ANCA). The illness can develop at any age but is more common in patients in their 50s and 60s and in men. The incidence of vasculitis is increasing, with about 10-20 people per million affected. We present a case that in retrospect had many clues at the initial time of admission, but it took five months and six different hospital teams to make the diagnosis.