A Patient with Wegener's Granulomatosis with Initial Clinical Presentations of Henoch-Schönlein Purpura

Masayuki MIYATA; Kaori KANNO; Tomoe NISHIMAKI; Fumitaka SAKUMA; Keiji IWATSUKI; Reiji KASUKAWA

doi:10.2169/internalmedicine.40.1050

Masayuki MIYATA, Kaori KANNO, Tomoe NISHIMAKI, Fumitaka SAKUMA, Keiji IWATSUKI, Reiji KASUKAWA

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Keywords: leukocytoclastic vasculitis, pulmonary hemorrhage, antineutrophil cytoplasmic antibody (ANCA), cytoplasmic-pattern antineutrophil cytoplasmic antibody (cANCA), proteinase 3 antineutrophil cytoplasmic antibody (PR3-ANCA), polyangiitis overlap syndrome

JOURNAL FREE ACCESS

2001 Volume 40 Issue 10 Pages 1050-1054

DOI https://doi.org/10.2169/internalmedicine.40.1050

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Abstract

The initial presentation of a patient with Wegener's granulomatosis was indistinguishable from that of Henoch-Schönlein purpura. The patient presented with skin purpura and pulmonary hemorrhage followed by purpura in the colon. The diagnosis of this patient at that time was Henoch-Schönlein purpura. With time, massive lesions in the sinus and those with cavities in the lung became apparent, and a specimen obtained from the sinus massive lesion was disclosed to be granulomatous inflammation. Retrospectively, the proteinase 3 antineutrophil cytoplasmic antibody turned out to be strongly positive in her stored serum from the time of the initial presentation.
(Internal Medicine 40: 1050-1054, 2001)

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