Images in emergency medicine. Wegener's granulomatosis: a rare presentation.

摘要

A 17-year-old female non-smoker presented to our emergency medicine department reporting 3 days of left-sided pleuritic chest pain associated with a cough productive of brown sputum. There was no associated dyspnoea, haemoptysis or fever. She was seen in rheumatology clinic previously for symmetrical small joint arthritis. The impression was early rheumatoid arthritis. Examination revealed dullness to percussion in the left midzone with normal breath sounds; there were no remarkable findings elsewhere. C-reactive protein measured 252, platelets 469 and D-dimer >1000. The chest radiograph showed two masses in the left midzone and mediastinal lymphadenopathy.