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KMID : 0388220130200030181
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Journal of the Korean Rheumatism Association
2013 Volume.20 No. 3 p.181 ~ p.185
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A Case of Wegener’s Granulomatosis with Central Nervous System Involvement Mimicking Lung Cancer with Brain Metastasis
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Park Joo-Hee
Lee Young-Ho
Ji Jong-Dae
Song Gwan-Gyu
Lee Soon-Wook
Yoo Seu-Hee
Ryu Ja-Young
Kim Hae-Rim
Kang Keun-Hee
Kang Seong-Hee
Kim Sun-Wha
Choi Sung-Jae
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Abstract
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Wegener’s granulomatosis (WG) classically consists of necrotizing granulomatous inflammation of the upper and/or lower respiratory tract, necrotizing glomerulonephritis, and an autoimmune necrotizing systemic vasculitis affecting predominantly small vessels. We report a case of WG with central nervous system (CNS) involvement. WG is being diagnosed through pulmonary nodule biopsy. A small nodular lesion in the left posterior basal ganglia of brain being highly suspicious for granulomatosis was detected by MRI. After IV pulse cyclophosphamide and oral corticosteroid treatment for over 4 months, clinical manifestations and CNS lesions in brain MRI is improved. WG might have multiple granulomatous lesions which could be misdiagnosed due to malignancy. CNS involvement in WG is rare but careful evaluation is necessary when there are suspicious symptoms or lesions in CNS.
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KEYWORD
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Wegener’s granulomatosis, Central nervous system involvement, Antineutrophil cytoplasmic antibody- associated vasculitis
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