We present a case of Wegener’s granulomatosis (WG) that responded
to antituberculous drugs. A 44-year-old woman with multiple nodules on
chest radiograph received a diagnosis of pulmonary tuberculosis because
open-lung biopsy specimens showed caseous granulomas. Her chest shadows
underwent repeated resolution after the start of antituberculous
treatment, and relapse after the cessation of the drugs. Antineutrophil
cytoplasmic antibody was positive (14 enzyme-linked immunosorbent assay
units), and the second lung biopsy specimens showed necrotizing
granulomas and vasculitis without pathogenic organisms. Thus, the
patient received a diagnosis of WG and was successfully treated with
trimethoprim/sulfamethoxazole 10 years after her initial evaluation.
Antituberculous drugs were effective in this case of WG.