Do pulmonary findings of granulomatosis with polyangiitis respond to anti-tuberculosis treatment?
Granulomatosis with polyangiitis (GPA) involves upper and lower respiratory tracts and kidneys. Lung involvement is among the most important organ involvements in GPA. GPA’s lung involvement might be confused with other granulomatous conditions with lung involvement. In this report, we presented clinical features of two cases with GPA who had been diagnosed as tuberculosis (TBC) and well treated with anti-tuberculosis (anti-TBC) drugs. However, one of two cases had ear–nose–throat (ENT) manifestations before the diagnosis of TBC and her extrapulmonary findings related with GPA have added to clinical features in the following years. In the second case, the manifestations of GPA appeared after 13 months of anti-TBC treatment. We speculated that lung involvement in these cases may be due to GPA rather than TBC. Our aim was to highlight difficulties in the differential diagnosis between GPA and TBC and suggest the possible beneficial effect of anti-TBC drugs on the lung involvement due to GPA in light of the literature data.
KeywordsWegener granulomatosis Granulomatosis with polyangiitis Tuberculosis Anti-tuberculosis treatment
Compliance with ethical standards
Conflict of interest
The authors declare that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent was obtained from our patients.
- 1.Calabrese LH, Molloy ES, Duna G (2009) Antineutrophilic cytoplasmic antibody-associated vasculitis. In: Firestein GS, Budd EC, Harris ED, Mc Innes IB, Ruddy S, Sergent JS (eds) Kelley’s textbook, 8th edn. Elsevier, Philadelphia, pp 1429–1451Google Scholar
- 3.Khilnani GC, Banga A, Sharma SC, Gupta SD (2003) Wegener’s granulomatosis: an isolated lung mass responding to antituberculosis therapy and atypical course. J Assoc Phys India 51:731–733Google Scholar
- 10.Hayashi H, Morimoto K, Nakazawa K, Fujita J, Mori T, Sunada K, Watanabe K, Hayashihara K, Saito T, Kawabata Y (2007) A case of limited form of Wegener’s granulomatosis showing repeated occurrence and disappearance of nodules in chest X ray with no medication. Nihon Kokyuki Gakkai Zasshi 45:726–730PubMedGoogle Scholar
- 12.Nilsson BS (1971). Rifampicin: an immunosuppressant? Lancet 2:p 374Google Scholar
- 15.Galal SH, Khalil SH, el Husseiny W, Brock J (1988) Cell mediated and humoral immunity and light-chain proteinuria in rifampicin-treated tuberculous patients. Allerg Immunol (Leipz) 34:249–254Google Scholar