Larry Greenbaum, MD
To the editors: I read the review on Wegener granulomatosis by Hoffman and colleagues (1) with great interest. Treatment with trimethoprim sulfamethoxazole (TMP-SMX) may be a useful alternative in selected patients (2, 3), as the following case suggests.
A 34-year-old man presented with left nasal obstruction due to a large inverted papilloma. He had extensive nasal surgery. Three months later, he developed migratory arthralgia and arthritis, an 8-kg weight loss, infiltrates on chest radiograph, and rapidly rising blood urea nitrogen (BUN) and creatinine levels. Evidence of granulomatous vasculitis consistent with Wegener granulomatosis was found on the original pathology specimens. In
Greenbaum L. Wegener Granulomatosis. Ann Intern Med. ;117:619–621. doi: 10.7326/0003-4819-117-7-619_2
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Published: Ann Intern Med. 1992;117(7):619-621.
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