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J Yeungnam Med Sci > Volume 30(1); 2013 > Article
Yeungnam University Journal of Medicine 2013;30(1):17-20.
DOI:    Published online June 30, 2013.
A Case of ANCA-Negative Generalized Wegener's Granulomatosis.
Seung Kyu Kim, Yong Jin Kwon, Heae Surng Park, Kwang Won Rhee, Ji Yoon Ha, Hee Sung Ko, Ki Hyun Kim, Min Kwang Byun
1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. LITTMANN@YUHS.AC
2Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Wegener's granulomatosis is a very rare systemic vasculitis characterized by necrotizing granulomatosis. The detection of antineutrophil cytoplasm antibody (ANCA) is a valuable finding in diagnosing Wegener's granulomatosis because ANCA is positive in approximately 90 percent of patients with active, generalized Wegener's granulomatosis. But ANCA is not necessarily positive to make a diagnosis. A 59-year-old man was transferred to our hospital. He was diagnosed with lung abscess and treated with antibiotics at previous hospital. Initially, the ANCA was negative in immunofluorescence assay but we suspected Wegener's granulomatosis because of systemic inflammatory symptoms. Clinical symptoms deteriorated rapidly so we did bronchoscopic biopsy early. Wegener's granulomatosis was diagnosed according to pathologic finding that reported necrotizing granulomatous inflammation associated with vasculitis. Thus we treated with steroid then clinical symptoms and laboratory findings were improved.
Key Words: Wegener's granulomatosis, ANCA


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