Summary
We describe a 55-year old female with an erosive symmetric polyarthritis and negative rheumatoid factor tests. A preliminary diagnosis was made of sero-negative rheumatoid arthritis. About two years after the first signs of arthritis, a diagnosis was made of Wegener's granulomatosis, based on bloody nasal discharge with active inflammation of the nasal mucosa with giant cells, the development of a saddle nose deformity, micro-haematuria and a strongly positive test for c-ANCA. After treatment with prednisone and cyclophosphamide the patient markedly improved. Wegener's granulomatosis has to be considered in a patient presenting with (erosive) (poly) arthritis.
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Borg, E.J.T., Disch, F.J.M. & Kallenberg, C.G.M. Erosive polyarthritis as presenting manifestation of Wegener's granulomatosis. Clin Rheumatol 14, 551–553 (1995). https://doi.org/10.1007/BF02208153
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DOI: https://doi.org/10.1007/BF02208153