[A case of refractory Wegener's granulomatosis successfully treated with high-dose methotrexate].

Abstract

We report a case of generalized Wegener's granulomatosis (WG) successfully treated with high-dose methotrexate (MTX) and predonisolone (PSL). A 35 year-old men had complaints of auditory disturbance and nasal hemorrhage. Diagnosis of WG was made based on positive proteinase-3 anti-neutrophil cytoplasmic antibody (PR3-ANCA), lung nodules, and focal necrotizing glomerulonephritis revealed by renal biopsy. Treatment with cyclophosphamide (CY) and PSL for 3 months was ineffective for the lung nodules. Then, CY was changed to high dose MTX (18mg/week), and his lung lesions improved. In Japan, it is unusual to treat WG with high-dose MTX, but this treatment may be useful in CY-resistant WG.

• Authors: Takashi Shimizu, Natsue Shimizu, Toshinori Takada, Fumitake Gejyo, Takashi Hasegawa, Eiichi Suzuki
• Journal: Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society (Nihon Kokyuki Gakkai Zasshi) Vol. 44 Issue 11 Pg. 853-7 (Nov 2006) ISSN: 1343-3490 [Print] Japan
• PMID: 17144586 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunosuppressive Agents
• Cyclophosphamide
• Prednisolone
• Methotrexate

Topics

• Adult
• Cyclophosphamide (pharmacology)
• Drug Administration Schedule
• Drug Resistance
• Granulomatosis with Polyangiitis (diagnostic imaging, drug therapy)
• Humans
• Immunosuppressive Agents (administration & dosage)
• Male
• Methotrexate (administration & dosage)
• Prednisolone (administration & dosage)
• Radiography, Thoracic
• Tomography, X-Ray Computed