Cavitary lesions are chacteristically seen in
Correct Answer: Wegeners granulomatosis
Description: Ans bLung involvement typically appears as multiple, b/L nodular cavitary infil-trate. Biopsy almost invariably shows typical necrotizing granulomatous vasculitis of small arteries and veins together with granuloma formation. WG is a distinct clinicopathological entity characterised by a granuloma-tous vasculitis of upper and lower resptract together with glomerulone-phritis. In addition variable degree of disseminated vasculitis involving both small arteries and veins may occur.Glomerulo nephritis may evolve to rapidly progressive crecentic glomeru-lonephritisIn contrast to others glomerulo nephritis evidence of immunocomplex depo-sition is not found in renal lesions of WegenersWegeners granulomatosis C/F - Kidney- GlomerulonephritisEnt- sinusitis, nasal discharge, otitis media, hearing loss, sub glottis stenosisLung- Pulmonary infiltrates, nodules, hemoptysis, pleuritis Eyes - conjunctivitis, dacrocystitis, scleritis, proptosis, visual loss. Others- arthralgia, fever, cough, skin lesions, wt loss, peripheral neuropa-thyLab- increased ESR. mild anemia, leukocytosis, mild hyper gamma globulinemia (particularly class IgA), mildly elevated RA factor. 90% have positive antiproteinase-3 ANCARx* cyclophosphamide induction for severe disease.* glucocorticoid gives symptomatic relief with little effect on ultimate outcome.Best is combining cyclophophamide and glucocorticoid.* In immediate life threatening conditions glucocorticoid + cyclo. For remission- 3-6m followed by methotrexate/ azathioprine for maintenance.
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