eMedicine Specialties > Neurology > Inflammatory and Demyelinating Diseases
Wegener Granulomatosis: Follow-up
Updated: Nov 25, 2008
Follow-up
Further Outpatient Care
Patients with Wegener's granulomatosis require close follow-up for response to therapy, potential relapse, and medication toxicity (serial chest radiographs, renal function tests, liver function tests, CBC count, urinalysis, and specific neurologic tests such as neuroimaging). For example, in patients with active CNS inflammation clinically or by MRI, repeat MRI with contrast every 1-3 months would be reasonable.
Miscellaneous
Medicolegal Pitfalls
Because Wegener's granulomatosis is a treatable condition, failure to diagnose early could be seen as substandard care if presenting symptoms are classic. However, given the rarity of Wegener's granulomatosis and its protean manifestations, standard of care is difficult to establish. Early diagnosis might be made possible by maintaining a low threshold for ordering c-ANCA antibody testing.
More on Wegener Granulomatosis |
| Overview: Wegener Granulomatosis |
| Differential Diagnoses & Workup: Wegener Granulomatosis |
| Treatment & Medication: Wegener Granulomatosis |
Follow-up: Wegener Granulomatosis |
| References |
| « Previous Page |
References
Nishino H, Rubino FA, DeRemee RA, Swanson JW, Parisi JE. Neurological involvement in Wegener's granulomatosis: an analysis of 324 consecutive patients at the Mayo Clinic. Ann Neurol. Jan 1993;33(1):4-9. [Medline].
Bachmeyer C, Cadranel JF, Demontis R. Rituximab is an alternative in a case of contra-indication of cyclophosphamide in Wegener's granulomatosis. Nephrol Dial Transplant. Jun 2005;20(6):1274. [Medline].
Bellisai F, Morozzi G, Marcolongo R, Galeazzi M. Pregnancy in Wegener's granulomatosis: successful treatment with intravenous immunoglobulin. Clin Rheumatol. Dec 2004;23(6):533-5. [Medline].
Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 9-1999. A 74-year-old woman with hydrocephalus and pleocytosis. N Engl J Med. Mar 25 1999;340(12):945-53. [Medline].
Drachman DD. Neurological complications of Wegener's granulomatosis. Arch Neurol. 1963;8:144-55.
Fauci AS, Haynes BF, Katz P, Wolff SM. Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. Ann Intern Med. Jan 1983;98(1):76-85. [Medline].
Howell SB, Epstein WV. Circulating immunoglobulin complexes in Wegener's granulomatosis. Am J Med. Feb 1976;60(2):259-68. [Medline].
Kelley WN, Harris ED, Ruddy S, Sledge CB. Textbook of Rheumotology. Vol 2. 5th ed. Philadelphia, Pa: WB Saunders; 1997.
Kerr GS, Fleisher TA, Hallahan CW, Leavitt RY, Fauci AS, Hoffman GS. Limited prognostic value of changes in antineutrophil cytoplasmic antibody titer in patients with Wegener's granulomatosis. Arthritis Rheum. Mar 1993;36(3):365-71. [Medline].
Moore PM. Immune-mediated vasculopathies of the central nervous system. In: Gilchrist J, ed. Prognosis in Neurology. Boston, Mass: Butterworth-Heinemann; 1998.
Scott DG, Watts RA. Classification and epidemiology of systemic vasculitis. Br J Rheumatol. Oct 1994;33(10):897-9. [Medline].
Spranger M, Schwab S, Meinck HM, Tischendorf M, Sis J, Breitbart A, et al. Meningeal involvement in Wegener's granulomatosis confirmed and monitored by positive circulating antineutrophil cytoplasm in cerebrospinal fluid. Neurology. Jan 1997;48(1):263-5. [Medline].
Tervaert JW, Huitema MG, Hené RJ, Sluiter WJ, The TH, van der Hem GK, et al. Prevention of relapses in Wegener's granulomatosis by treatment based on antineutrophil cytoplasmic antibody titre. Lancet. Sep 22 1990;336(8717):709-11. [Medline].
Travis WD, Hoffman GS, Leavitt RY, Pass HI, Fauci AS. Surgical pathology of the lung in Wegener's granulomatosis. Review of 87 open lung biopsies from 67 patients. Am J Surg Pathol. Apr 1991;15(4):315-33. [Medline].
Wegener F. [Uber eine eigenartige rhinogene Granulomatose mit besonderer Beteilgung des Arteriensytems und der Nieren]. Beitrage der Pathologischen Anatomie. 1939;102:30-68.
Further Reading
Keywords
Wegener's granulomatosis, granuloma, lymphomatoid granulomatosis, necrotizing inflammation, autoimmune disease, autoantibodies, neutrophil cytoplasmic antibodies, ANCA, c-ANCA, vasculitis, vasculitides, arteritis
Follow-up: Wegener Granulomatosis