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Chest, Vol 105, 509-513, Copyright © 1994 by American College of Chest Physicians


ARTICLES

Radiographic course of pulmonary manifestations in Wegener's granulomatosis under immunosuppressive therapy

W Grotz, A Mundinger, G Wurtemberger, HH Peter and P Schollmeyer
Department of Medicine, University of Freiburg, Germany.

Eleven patients with generalized Wegener's granulomatosis were studied. Pulmonary involvement occurred 1 month earlier than a rapid rise of serum creatinine value. Under immunosuppressive therapy, nodules and infiltrations abated slower in patients with bronchopulmonary superinfection (mean, 30 days) compared with patients without superinfection (mean, 18 days). In the short run, radiographic course was a better indicator for therapeutic success than the course of cytoplasmatic antineutrophil cytoplasm antibody titer. If the pulmonary findings did not begin to clear within 1 week after treatment had been started, either superinfection or insufficient immunosuppression was present. In this situation, a more aggressive therapy in combination with antibiotics is suggested.





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Copyright © 1994 by the American College of Chest Physicians.