Wegener's Granulomatosis Combined with Pulmonary Tuberculosis: Report of 8 Cases and Literature Review

  Objective  To analyze the clinical manifestations of patients with Wegener's granulomatosis (WG) and pulmonary tuberculosis (TB).

  Methods  We retrospectively analyzed the clinical data of 8 patients with Wegener's granulomatosis combined with pulmonary tuberculosis in Peking Union Medical College Hospital from May 1990 to May 2010.

  Results  There were 5 men and 3 women aged 19-70 years. Five patients were initially diagnosed as Wegener's granulomatosis but were confirmed to be with pulmonary tuberculosis during corticosteroid therapy. All these five patients had positive acid-fast bacilli smear test results, and four of them denied past a history of tuberculosis or tuberculosis exposure. Two were diagnosed as Wegener's granulomatosis and pulmonary tuberculosis almost the same time. In the remaining one case, tuberculosis was diagnosed firstly, and then Wegener's granulomatosis was also identified. The most common clinical manifestation in lung was hemoptysis, followed by cough and expectoration. Other involved organs included kidney (abnormal red blood cells in urine) and ear/nose/throat (suppuration and hearing impairment). Management was mainly based on anti-TB therapy and enhanced corticosteroid therapy.

  Conclusions  Patients with Wegener's granulomatosis combined with pulmonary tuberculosis are not uncommon. Early diagnosis and treatment can improve the prognosis.