Mohammed Shahedur Rahman Khan1, ASM Ekram Uddin2, Nasreen Haque2, Biswas Shaheen Hassan3, Md. Ziaul Karim3, Mohammad Touhiduzzaman4, Mohammad Ashiqur Rahman4, Biswazit Biswas5, Ashok Kumar Bhoumick6.

Abstract
Granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis (WG) is a rare
multi-systemic disease characterized by necrotizing granulomatous inflammation of the upper and lower
respiratory tracts and general focal necrotizing vasculitis. The diagnosis of GPA is suggested from the
clinical and laboratory findings and from the presence of circulating anti-neutrophil cytoplasmic antibodies
(ANCA), although the absence of ANCA does not exclude the diagnosis. We described a case of 36 years
old man who was initially diagnosed as a case of pulmonary tuberculosis on the basis of FNAC from
pulmonary nodule. But later he developed poly-arthritis, abdominal pain and multiple purpuric rashes.
Finally he was diagnosed as a case of Granulomatosis with polyangiitis (Wegener’s granulomatosis) as
the skin biopsy showed leucocytoclastic vasculitis and c-ANCA found positive. In this report, we wanted to
emphasize that Wegener’s granulomatosis, although rare, should be considered in case of a suspicious
pulmonary nodule with multi-systemic involvement.
Keywords: Granulomatosis with polyangiitis (GPA), Anti-neutrophil cytoplasmic antibodies (ANCA),
Vasculitis, Pulmonary nodule.

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