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Spontaneous pneumothorax in Wegener's granulomatosis: a case report

  • Case Report
  • Published:
Modern Rheumatology

Abstract

Wegener's granulomatosis (WG) is a multiorgan system disease of unknown etiology characterized by granulomatous inflammation, tissue necrosis, and variable degrees of vasculitis in small- and medium-sized blood vessels. In patients with WG, the musculoskeletal system can be involved before other typical symptoms of the disease. Also in WG, pneumothorax can develop as a rare complication. In this paper, we report a case with WG who had early articular involvement in the absence of classic features of illness and had pneumothorax which resulted from the rupture of the sub-pleural nodule. The aim of this work is to increase the awareness of early articular involvement in WG and the pneumothorax possibility especially in cases with cavitated nodules closure to pleura. This case emphasizes that early diagnosis and treatment is very important in avoiding further complications.

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References

  1. Leavitt RY, Fauci AS, Bloch D, Michel BA, Hunder GG, Arend WP, et al. The American College of Rheumatology criteria for the classification of Wegener’s granulomatosis. Arthritis Rheum. 1990;33:1101–7.

    Article  PubMed  CAS  Google Scholar 

  2. Jennette JC, Falk RJ, Andrassy K, Bacon PA, Churg J, Gross WL, et al. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum. 1994;37:187–92.

    Article  PubMed  CAS  Google Scholar 

  3. Stone JH, Hofman GS. Wegener’s granulomatosis and lymphomatoid granulomatosis. In: Hoschberg MC, Silman AJ, Smolen JS, et al. (eds) Rheumatology, 3rd ed. St. Louis: Mosby; 2003. pp. 1635–48.

  4. Abdou N, Kullman G, Hoffman GS, Sharp GC, Specks U, McDonald T, et al. Wegener’s granulomatosis: survey of 701 patients in North America. Changes in outcome in the 1990s. J Rheumatol. 2002;29:309–16.

    PubMed  Google Scholar 

  5. Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, et al. Wegener's granulomatosis: an analysis of 158 patients. Ann Intern Med. 1992;116:488–98.

    PubMed  CAS  Google Scholar 

  6. Fauci AS, Haynes BF, Katz P, Wolff SM, et al. Wegener’s granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. Ann Intern Med. 1983;98:76–85.

    PubMed  CAS  Google Scholar 

  7. Koldingsnes W, Nossent H. Predictors of survival and organ damage in Wegener’s granulomatosis. Rheumatology. 2002;41:572–81.

    Article  PubMed  CAS  Google Scholar 

  8. Delevaux I, Khellaf M, Andre M, Michel JL, Piette JC, Aumaitre O. Spontaneous pneumothorax in Wegener's granulomatosis. Chest. 2005;128:3074–5.

    Article  PubMed  Google Scholar 

  9. Epstein DM, Gefter WB, Miller WT Gohel V, Bonavita JA. Spontaneous pneumothorax: an uncommon manifestation of Wegener's granulomatosis. Radiology. 1980;135:327–8.

    PubMed  CAS  Google Scholar 

  10. Jaspan T, Davison AM, Walker WC. Spontaneous pneumothorax in Wegener’s granulomatosis. Thorax. 1982;37:774–5.

    Article  PubMed  CAS  Google Scholar 

  11. Wolffenbuttel BH, Weber RF, Kho GS. Pyopneumothorax: a rare complication of Wegener’s granulomatosis. Eur J Respir Dis. 1985;67:223–7.

    PubMed  CAS  Google Scholar 

  12. Ogawa M, Azemoto R, Makino Y, Mori Y, Ueda S, Wakashin M, et al. Pneumothorax in a patient with Wegener’s granulomatosis during treatment with immunosuppressive agents. J Intern Med. 1991;229:189–92.

    Article  PubMed  CAS  Google Scholar 

  13. Bulbul Y, Ozlu T, Oztuna F. Wegener’s granulomatosis with parotid gland involvement, pneumothorax. Med Princ Pract. 2003;12:133–7.

    Article  PubMed  Google Scholar 

  14. Ates A, Karaaslan Y, Yıldız G, Gunesen O, Han S. A case of Wegener’s granulomatosis complicated with hydropneumothorax. J Clin Rheumatol. 2006;12:264–5.

    Article  PubMed  Google Scholar 

  15. Mies Richie A, Francis ML. Diagnostic approach to polyarticular joint pain. Am Fam Physician. 2003;68:1151–60.

    PubMed  Google Scholar 

  16. Pavelka K Jr, Dostal C, Rossmann P, Kraus H, Matousovic K, Vrabec J. Wegener’s granulomatosis with bilateral necrotizing scleritis, polyarthritis and renal failure efficiently treated with immunosuppressive therapy. Clin Rheumatol. 1986;5:112–7.

    Article  PubMed  Google Scholar 

  17. El-Gabalawy HS, Duray P, Goldbach-Mansky R. Evaluating patients with arthritis of recent onset: studies in pathogenesis and prognosis. JAMA. 2000;284:2368–73.

    Article  PubMed  CAS  Google Scholar 

  18. Brazzelli V, Vassallo C, Baldini F, Ravelli A, Martini A, Borroni G. Wegener's granulomatosis in a child: cutaneous findings as the presenting signs. Pediatr Dermatol. 1999;16:277–80.

    Article  PubMed  CAS  Google Scholar 

  19. Barksdale SK, Hallahan CW, Kerr GS, Fauci AS, Stern JB, et al. Cutaneous pathology in Wegener’s granulomatosis. A clinicopathologic study of 75 biopsies in 46 patients. Am J Surg Pathol. 1995;19:161–72.

    Article  PubMed  CAS  Google Scholar 

  20. Stein CM. Immunoregulatory drugs. In: Ruddy S, Harris ED (eds) Kelley’s textbook of rheumatology. 6th edn., Philadelphia: WB Saunders Company, 2001. pp. 879–98.

    Google Scholar 

  21. Guillevin L, Cordier JF, Lhote F, Cohen P, Jarrousse B, Royer I, et al. A prospective, multicenter, randomized trial comparing steroids and pulse cyclophosphamide versus steroids and oral cyclophosphamide in the treatment of generalized Wegener’s granulomatosis. Arthritis Rheum. 1997;40:2187–98.

    Article  PubMed  CAS  Google Scholar 

  22. Hoffman GS, Leavitt RY, Fleisher TA, Minor JR, Fauci AS. Treatment of Wegener’s granulomatosis with intermittent high-dose intravenous cyclophosphamide. Am J Med. 1990;89:403–10.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Akdeniz University, Antalya, Turkey

    Ilhan Sezer, Hilal Kocabas, Meltem Alkan Melikoglu, Bayram Serdar Budak & Bulent Butun

  2. Department of Pathology, Faculty of Medicine, Akdeniz University, Antalya, Turkey

    Irem Hicran Ozbudak

Authors
  1. Ilhan Sezer
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  2. Hilal Kocabas
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  3. Meltem Alkan Melikoglu
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  4. Bayram Serdar Budak
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  5. Irem Hicran Ozbudak
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  6. Bulent Butun
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Corresponding author

Correspondence to Ilhan Sezer.

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Sezer, I., Kocabas, H., Melikoglu, M.A. et al. Spontaneous pneumothorax in Wegener's granulomatosis: a case report. Mod Rheumatol 18, 76–80 (2008). https://doi.org/10.1007/s10165-007-0007-y

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  • DOI: https://doi.org/10.1007/s10165-007-0007-y

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