A man with Wegener's granulomatosis and haemoptysis

doi:10.1136/bmj.b1461

Published 22 April 2009, doi:10.1136/bmj.b1461
Cite this as: BMJ 2009;338:b1461

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A man with Wegener’s granulomatosis and haemoptysis

Richard Lee, ST2 academic clinical fellow, allergy and respiratory medicine, Rhodri Martin, ST1 core medical training , David D’Cruz, consultant rheumatologist

¹ Lupus Research Unit, Rayne Institute, St Thomas’ Hospital, London SE1 7EH

Correspondence to: D D’Cruz david.d'cruz@kcl.ac.uk

The first 150 words of the full text of this article appear below.

A 60 year old man with Wegener’s granulomatosis who wasclinically stable on methotrexate presented with a two day historyof haemoptysis. On examination he was febrile, with bibasalcrepitations and bronchial breath sounds in the left upper zone.

Pulse oximetry showed an oxygen saturation of 96% on air. Afull blood count showed that his haemoglobin was 134 g/l, whiteblood cells were 18.4x10⁹/l (neutrophils 15.3x10⁹/l), and serumcreatinine was 74 µmol/l. He had a titre of 1:160 on recentserological testing for cytoplasmic staining antineutrophilcytoplasmic antibodies.

Urinalysis detected trace amounts of protein and blood, buthe had no dysmorphic red cells or casts on urine microscopy.

He underwent computed tomography of the chest and chest radiography(figs 1 and 2).