Therapeutic Menagement In Wegener's Granulomatosis (W.G.) Patients

Journal/Book: Z Rheumatol 1998; 57 Suppl. 1: 81 (P 147). 1998;

Abstract: Warsaw Poland Wegener's granulomatosis is one of the forms of necrotic systemic vasculitis that affects upper and lower respiratory tract as well as renal glomerules. Ethiopatogenesis of the disease remains unclear. Involvement of respiratory system suggests hypersensitivity to extra or intragenous antigen in the respiratory epithelium. Thus antibacterial drugs in addition to immunosuppresive treatment seems to be of great value. Aim: To observe the efficacy of combined treatment (prednison cyclophosphamide trimetoprim/sulfametoxasol) in Wegener's granulomatosis patients. Patients and methods: 6 patients with W. g. were observed (F:M = 4:2 aged from 31 to 52 mean 39.83). Disease duration lasted 2 to 144 months mean 37 months. From the moment of the start of combined therapy the observation lasted 12 to 96 months. In all patients the diagnosis was made according to the ARA criteria and confirmed by typical changes in histopatological examination. As diagnosed all patients received treatment with prednison (not less then 1 mg per kg of body weight at the begining of the treatment) cyclophosphamide (1 g monthly i. v.) and trimetoprim/sulfametoxasol (960 mg twice daily oraly for 10 consecutive days each month). Results: 5 of 6 patients presented inflammatory changes in upper respiratory tract as a first symptoms of the disease. Only one patient started medical history with pseudotumor of orbit. At the clinical examination all patients presented fever and respiratory tract involvement. Arthritis nephritis and cardiac system involvement were observed in 4 patients pharyngitis sinusitis medial otitis - in 3 patients. Two patients had central nervous system and one cranial nerves involvement. In 2 cases skin vasculitis was present. ... le

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