Treatment of Wegener's Granulomatosis With Immunosuppressive Agents

More than 100 cases of Wegener's granulomatosis have been described since the original reports of Klinger in 1931 and Wegener in 1936. Clinically, the disease is characterized by a severe progressive sinusitis; cough; and finally, in the majority of cases, by renal failure.1,2Pathologically it has been characterized by necrotizing granulomatous lesions in the upper or lower respiratory tract, focal glomerulitis, and generalized focal necrotizing vasculitis.3-5 The prognosis in Wegener's granulomatosis has been extremely poor, despite the use of antibiotics, radiation therapy, and steroids.2,4,6In the last seven years, however, there have been scattered reports of its successful treatment with alkylating or immunosuppressive agents. Since there is evidence that this process may be related to an immunologic or hypersensitivity state,1,5the use of immunosuppression seems justified. Patient Summary A 29-year-old white man (467 044) was admitted to university hospital May 13, 1968, with a chief complaint