Wegner's granulomatosis
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Transcript of Wegner's granulomatosis
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Wegner’s Granulomatosis
Dr/ Hytham Nafady
Hertz
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Definition
Multisystem disease of unknown etiology characterized by
• Granulomatous necrotizing small vessel vasculitis of the upper & lower respiratory tract &
• Glomerulonephritis.
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Wegner’s granulomatosis involves the
• upper respiratory tract in 100% of cases,
• lower respiratory tract in 90% of cases &
• kidneys in 80% of cases, &
• Tracheo-bronchial tree in 60% of cases.
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Demographics
• Age: around 45.
• M>F
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C.P
• Rhinitis, sinusitis & epistaxis.
• Cough & hemoptysis.
• Hematuria & Chronic renal failure, which is the cause of death.
• Lab: elevated (c-ANAC) antineutrophil antibodies.
• Renal biopsy: glomerulonephritis, which is diagnostic.
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Radiological manifestations
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Respiratory manifestations of
Wegner’s granulomatosis
Nodules Alveolar opacities
Airways
Ground glass
opacitiesConsolidation
Subglottic tracheal stenosis
Bronchial stenosis
Cavitating
Non cavitating
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Rare manifestations of WG
• Interstitial abnormalities (thickening of interlobular sepat).
• Hilar lymphadenopathy.
• Pleural thickening or effusion.
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Nodules
• Single or multiple.
• Small or large (few mm to 10 cm).
• Cavitating or non cavitating.
• Thin walled (1-3 mm) or thick walled (> 3 mm) cavities.
• Halo sign (due to surrounding alveolar hemorrhage).
• Reversed halo sign.
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Halo sign
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Reversed halo sign
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Alveolar WG
Due to alveolar hemorrhage.
Alveolar WG
Ground glass opacities Consolidation
Centrilobular nodules Patchy distribution
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Centrilobular nodules of GG density
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GGO with patchy distribution
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Consolidation
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Airway WG• Subglottic tracheal stenosis.• Bronchial stenosis
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Case
27-year-old woman involved in a severe motor vehicle collision years ago with a prolonged hospital course now presents with a several months history of progressive dyspnea.
• What is the pertinent radiologic finding?
• What is your differential diagnosis?
• What is your favorite diagnosis?
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DD of tracheal stenosis
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