Wegener's granulomatosis

Wegener's granulomatosis is characterized by necrotizing granulomatous lesions of the upper respiratory tract and/or lungs, necrotizing vasculitis and focal glomerulonephritis, terminating usually in uremia. Two additional cases are reported, bringing the total in the literature to thirty-seven. In Case I an initial erroneous diagnosis of tuberculosis was made histopathologically from the resected segment of lung and from autopsy material. Death was due to spontaneous subarachnoid hemorrhage complicating arteritis. This complication, and the cerebral lesions found at autopsy in Case II, have not hitherto been reported in this disease. The spectrum formed by this and other conditions closely related to polyarteritis nodosa is discussed. A hypersensitivity mechanism has been inferred by most authors but its nature remains to be elucidated. Treatment of this disease so far has been unsatisfactory.