| Abstract | Gangrene of digits is a very rare manifestation of Wegener's granulomatosis (WG). We report a case of a 29-year-old woman with nonspecific symptoms like fever, weight loss, arthralgia, arthritis and high systemic inflammatory signs. On the grounds of a presumed infection the patient was treated with antibiotics which showed no effect. Within short she complained of pain and paresthesia of the right foot with a rapid lividity. Angiography demonstrated multiples stenoses and multisegmental occlusions of the lower leg arteries. Together with renal and pulmonal symptoms a WG was suspected, the diagnosis being confirmed by kidney biopsy and positive cANCAs. A few months after starting a combined therapy with cyclophosphamide and corticosteroids the patient showed a partial remission with a residual toe gangrene. Comparing the five worldwide reported cases with digital gangrene and our presentation there is a concordance of all in the occurrence of an extremely high disease activity together with a glomerulonephritis. The findings of p-ANCAs in our patient and positive Hbs antigen in another case of WG with digital gangrene suggests a relation to panarteriitis nodosa, where gangren is more common. |
| Authors | C Binder, M Schattenkirchner, K Krüger
(Affiliation: Rheuma-Einheit und Medizinische Poliklinik der LMU München.)
|
| Journal | Zeitschrift für Rheumatologie
(Z Rheumatol)
Vol. 57
Issue 4
Pg. 227-30
(Aug 1998)
ISSN: 0340-1855 GERMANY |
| Vernacular Title | Schwere Zehengangrän als frühe Manifestation der Wegener-Granulomatose bei einer jungen Patientin. |
| PMID | 9782604
(Publication Type: Case Reports, English Abstract, Journal Article)
|
| Chemical References |
- Antibodies, Antineutrophil Cytoplasmic
|
| Topics |
- Adult
- Antibodies, Antineutrophil Cytoplasmic
(blood)
- Female
- Gangrene
- Humans
- Polyarteritis Nodosa
(diagnosis)
- Toes
(pathology)
- Wegener Granulomatosis
(diagnosis)
|
