Presentation
Worsening kidney function. Recent onset hemoptysis on a background of chronic cough. Longstanding paranasal sinus disease.
Patient Data
Age: 32 years old
Gender: Female
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Bilateral mucosal thickening with bony thinning. Perforation of the nasal septum is also seen.
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Few randomly scattered lung nodules are seen bilaterally, some show cavitary change with thick walls.
Case Discussion
The lung nodules seen in this case can be due to septic emboli, metastasis or vasculitis. The fact that the patient also has upper respiratory tract involvement, a positive c-ANCA lab result and probable renal system involvement, makes vasculitis in the form of Wegener granulomatosis the more likely diagnosis.
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