[Atypical presentation of Wegener disease in childhood]

J Mal Vasc. 2008 Dec;33(4-5):242-6. doi: 10.1016/j.jmv.2008.09.007. Epub 2008 Nov 20.
[Article in French]

Abstract

The pediatric forms of Wegener granulomatosis (WG) are rare. The clinical picture and the profile have specificities compared to those of adults. We report a case of a girl aged of four years and a half who presented initially with a clinical picture of Henoch Schönlein purpura. Physical examination revealed additionally to purpura, scabby lesions on the buttocks. The histopathological examination of a skin biopsy disclosed histiocyte infiltration. There were no Ig A deposits on direct immunofluorescence study. One year later, the diagnosis of WG was suspected, when the patient developed a respiratory problem related to left pulmonary infarction. Screening for thromboembolic factors was positive for antiphosphilipid antibodies. Diagnosis of WG was confirmed by the histopathological study lung tissue and a significant titre of serum ANCA. Blood tests failed to provide evidence of renal involvement. Cyclophosphamide and prednisolone therapy was administrated. A relapse occurred one year later on the controlateral lung; but no biological marker of disease activity could be detected.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Granulomatosis with Polyangiitis / diagnosis*
  • Granulomatosis with Polyangiitis / diagnostic imaging
  • Granulomatosis with Polyangiitis / pathology
  • Humans
  • Inflammation / pathology
  • Lung / pathology*
  • Lung Abscess / pathology
  • Radiography, Thoracic
  • Tomography, X-Ray Computed