Digital gangrene a rare early manifestation of Wegener’s granulomatosis: a case report

Authors

  • Akash Mathur SMS Medical College and Hospital, Jaipur, Rajasthan
  • Dinesh Gurjar SMS Medical College and Hospital, Jaipur, Rajasthan
  • Arvind Lakesar SMS Medical College and Hospital, Jaipur, Rajasthan
  • Ramkrishna Sai SMS Medical College and Hospital, Jaipur, Rajasthan
  • Aradhana Singh SMS Medical College and Hospital, Jaipur, Rajasthan
  • Hemant Malhotra SMS Medical College and Hospital, Jaipur, Rajasthan

DOI:

https://doi.org/10.18203/2320-6012.ijrms20160554

Keywords:

Wegener's granulomatosis, Granulomatosis with polyangiitis, Digital gangrene

Abstract

Wegener's granulomatosis (WG) or Granulomatosis with polyangiitis (GPA) rarely presents with digital gangrene being an early manifestation. We report a case of 60-year-old woman who presented with fever and cough with occasional hemoptysis along with painful bilateral feet digital gangrene. X ray chest and HRCT thorax of the patient was suggestive of multiple nodulo-cavitatory lesions. HPE of the lung lesion showed granulomatous pathology. CT Angiography was suggestive of multiple calcified and non-calcified lesions in infra renal aorta with stenosis of right dorsalis pedis artery. Biopsy of the skin lesion revealed a leucocytoclastic vasculitis. We eventually diagnosed GPA in light of clinical symptomatology with HPE of lung mass showing granulomatous lesion along with a positive cANCA. A few months after starting combined cyclophosphamide and steroids patient had significant symptomatic improvement. Hence Wegener’s granulomatosis should always be considered as a possibility while evaluating a patient of digital gangrene specially with pulmonary and renal involvement.

References

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Published

2016-12-27

How to Cite

Mathur, A., Gurjar, D., Lakesar, A., Sai, R., Singh, A., & Malhotra, H. (2016). Digital gangrene a rare early manifestation of Wegener’s granulomatosis: a case report. International Journal of Research in Medical Sciences, 4(3), 942–946. https://doi.org/10.18203/2320-6012.ijrms20160554

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Section

Original Research Articles