Summary
A 27-year-old woman presented with destructive scleritis of the left eye with subcutaneous haemorrhage and swelling of the lower eyelid. She had experienced recurrent nasal bleeding for the last six years, and chronic sinusitis resulting in the destruction of the nasal septum and left maxillary sinus. Nasal mucosal biopsies demonstrated granuloma formation with no evidence of vasculitis. The level of serum cytoplasmic anti-neutrophil cytoplasm antibody (c-ANCA) was significantly increased. Furthermore, multiple sites of complete occlusions were detected in the left subclavian and common carotid arteries by subtraction angiography and MRI. We describe a case of Wegener's granulomatosis overlapped with Takayasu arteritis, which, to our knowledge, has not been previously reported.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hall, S., Barr, W., Lie, J.T., Stanson, A.W., Kazmier, F.J., Hunder, G.G. Takayasu's arteritis: a study of 32 North American patients. Medicine 1985, 64, 89–99.
Nakao, K., Ikeda, M., Kimura, S., Niitani, H., Miyahara, M. Takayasu's arteritis: clinical report of eighty-four cases and immunological studies of seven cases. Circulation 1967, 35, 1141–1155.
Tanigawa, K., Eguchi, K., Kitamura, Y., Kawakami, A., Ida, H., Yamashita, S., Matsunaga, N., Hayashi, K., Nagataki, S. Magnetic resonance imaging detection of aortic and pulmonary artery wall thickening in the acute stage of Takayasu arteritis; Improvement of clinical and radiologic findings after steroid therapy. Arthritis Rheum 1992, 35, 476–480.
Grange, C., Caban, J., Dubois, A., Raphael, M., Chomette, G., Lamas, G., Godeau, P., Meyer, B., Imbert, J.C. Centrofacial malignant granulomas; Clinicopathological study of 40 cases and review of the literature. Medicine 1992, 71, 179–196.
Ovtchinnikoff, S., Blin, D., Rouanet, J-P., Lopez, F.M., Dubois, A. Computed tomography of lethal midline granuloma. 5 case reports. Eur J Radiol 1988, 8, 145–147.
van der Woude, F.J., Rasmussen, N., Lobatto, S., Wiik, A., Permin, H., van Es, L.A., van der Giessen, M., van der Hem, G.K. Autoantibodies against neutrophil and monocytes; tool for diagnosis and marker of disease activity in Wegener's granulomatosis. Lancet 1985, 1, 425–429.
Savage, C.O., Winearls, C.G., Jones, S., Marshall, P.D., Lockwood, C.M.: Prospective study of radioimmunoassay for antibodies against neutrophil cytoplasm in diagnosis of systemic vasculitis. Lancet 1987, 1, 1389–1393.
Hoffman, G.S., Kerr, G.S., Leavitt, R.Y., Hallahan, C.W., Lebovics, R.S., Travis, W.D., Rottem, M., Fauci, A.S., Wegener's granulomatosis: An analysis of 158 patients. Ann Intern Med 1992, 116, 488–498.
Lüdemann, J., Utecht, B., Gross, W.L. Detection and quantification of anti-neutrophil cytoplasm antibodies in Wegener's granulomatosis by ELISA using affinity-purified antigen. J Immunol Method 1988, 114, 167–174.
Schmitt, W.H., Csernok, E., Gross, W.L. ANCA and infection. Lancet 1991, 1, 1416–1417.
Klassen, R.J., Goldschmeding, R., Dolman, K.M., Ulekke, A.B., Weigel, H.M., Eeftinck Schattenkerk, J.K., Mudler, J.W., Westedt, M.L. Anti-neutrophil cytoplasmic autoantibodies in patients with symptomatic HIV infection. Clin Exp Immunol 1992, 87, 24–30.
Davenport, A. “False positive” perinuclear and cytoplasmic antineutrophil cytoplasmic antibody results leading to misdiagnosis of Wegener's granulomatosis and/or microscopic polyarteritis. Clin Nephrol 1992, 37, 124–130.
Fukase, S., Ohta, N., Inamura, K., Aoyagi, M., Koike, Y. Diagnostic specificity of anti-neutrophil cytoplasmic antibodies (ANCA) in otorhinolaryngological disease. Acta Oto-Laryngologica (Suppl.) 1994, 511, 204–207.
Lai, K.N., Jayne, D.R.W., Brownlee, A., Lockwood, C.M.: The specificity of anti-neutrophil cytoplasm autoantibodies in systemic vasculitides. Clin Exp Immunol 1990, 82, 233–237.
Leavitt, R.Y., Fauci, A.S. Polyangiitis overlap syndrome. Classification and prospective clinical experience. Am J Med 1986, 81, 79–85.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yamasaki, S., Eguchi, K., Kawabe, Y. et al. Wegener's granulomatosis overlapped with Takayasu arteritis. Clin Rheumatol 15, 303–306 (1996). https://doi.org/10.1007/BF02229714
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02229714