Wegener Granulomatosis Revealed by Pleural Effusion

Abstract EN

Pulmonary signs are common in Wegener's granulomatosis (WG).

However, an initial presentation including pleural effusion has not been described.

We describe a case of WG in which pleural effusion was the first clinical manifestation.

A 45-year-old man with dorsal pain presented with pleural thickening and effusion, and a visible nodule on a thoracic scan.

A dense chronic inflammatory infiltrate was obtained by pleural biopsy and an open lung biopsy revealed necrotizing granulomatous vasculitis.

Serologies were positive for antineutrophil cytoplasmic antibodies and antiproteinase 3 antibodies.

A diagnosis of WG was conducted and the patient was started on cyclophosphamide and methylprednisolone as an initial treatment, with a favorable evolution.

Although pleural effusion is rarely described in WG, this pathology must be considered in the presence of this clinical manifestation.