A case of Wegener's Granulomatosis with a markedly-elevated level of PR3-ANCA in the early stage

A Case of Wegener's Granulomatosis with a Markedly-elevated Level of PR3-ANCA in the Early Stage A 70-year-old woman was admitted to our hospital because of abnormal chest radiography. Her chest CT showed infiltrations in the upper lobe of her right lung, and these shadows improved after treatment with antibiotics. At this time, her serum PR3-ANCA showed over 300 EU. Four months later, her chest CT showed other infiltrations in the upper lobe of right lung, and she had cough, anemia, eruption and renal damage. Histopathologic findings from renal biopsy revealed Pauci-immune type crescentic glomerulonephritis. She was diagnosed as having Wegener's Granulomatosis. Her cough, renal damage, abnormality of chest radiograph and eruption were improved with prednisolone 50 mg/day and cyclophosphamide 100 mg/day. The proteinase 3-antineutrophil cytoplasmic antibody test is useful for diagnosis of Wegener's granulomatosis in the early stage.