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A 64-year-old man was admitted to the hospital because of a productive cough during treatment for suspected Wegener's granulomatosis.
The patient had been well until seven months earlier, when he began to have unsteadiness and right-sided tinnitus, with constant maxillary, nasal, frontal, and temporal pain, which was more prominent on the right side. Treatment with prednisone (40 mg daily) was begun, with considerable improvement of the headache. A biopsy of the left temporal artery showed no evidence of arteritis. Two months before admission, a test for antineutrophil cytoplasmic antibody (ANCA) was positive, with a perinuclear pattern of staining (P-ANCA), and
Differential Diagnosis
Clinical Diagnosis
Dr. Robert W. Simms's Diagnosis
Pathological Discussion
Anatomical Diagnosis
References
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