PURPOSE: Wegener's Granulomatosis (WG) is an uncommon disorder characterized by a triad of upper airway, pulmonary, and renal disease, but can involve any organ system. Physicians must be aware of the more common clinical features of the disorder when the patients are admitted to the hospital.
METHODS: We performed a retrospective review of 13 biopsy proven cases of WG presenting for admission to our University affiliated community hospital from 1999–2007. We collected information on demographics, clinical presentation, laboratory and radiographic findings, and cause of admission. We analyzed our data using simple descriptive statistics.
RESULTS: Of 13 patients with WG, six (46.2%) were female. Mean age was 59.7 (SD 18.1) and all were white. Average length of stay was 12.8 days (SD 16.6). Clinical features on admission included cough (69.2%), of which all were productive, hemoptysis (15.4%), sinus symptoms (30.8%), and nausea and/or vomiting (53.8%). We identified 8 patients who underwent cANCA testing, and 7 (87.5%) were positive, six (75%) of which had the classic triad of WG. Seven (53.8%) patients presented with a new infiltrate on chest radiograph, of which four (30.8%) were alveolar and three (23.1%) were multilobar involvement. The most common causes for admission were alveolar hemorrhage (3), community acquired pneumonia/sepsis (3), congestive heart failure exacerbation (2), and pneumothorax (2).
CONCLUSION: We found that the most common cause for admission in our group of patients was secondary to alveolar hemorrhage associated with cough which did not necessarily correlate with hemoptysis. Symptoms of other organ involvement like gastrointestinal manifestations were prominent in our study group. Furthermore the most common radiological manifestation was the presence of a new alveolar infiltration. Interestingly pneumothorax was a radiologic manifestation in 15% of patients. Our results also confirm the strong correlation between the classic triad and the cANCA levels.
CLINICAL IMPLICATIONS: The importance of our results helps the healthcare professional be aware of the diverse clinical and radiological features by which patients with WG can present to the hospital.
DISCLOSURE: Abdullah Altayeh, No Financial Disclosure Information; No Product/Research Disclosure Information