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Wegener's granulomatosis - Treatment

Alternative Names

Midline granulomatosis

Treatment:

Your doctor may suggest treatment with glucocorticoid (such as prednisone) and a cytotoxic drug, which is a medicine that kills cells or blocks their growth and function. Cytotoxic medicines are often used during chemotherapy.

Cytotoxic medicines used to treat Wegener's granulomatosis include:

  • Cyclophosphamide (Cytoxan)
  • Methotrexate
  • Azathioprine (Imuran)

These medicines may cause serious side effects. You should carefully discuss your treatment plan with your doctor.

Other medicines may be prescribed, including:

  • Bisphosphonate (Fosamax) to prevent bone loss due to prednisone use
  • Trimethoprim/sulfamethoxazole to prevent lung infections
  • Folic acid or folinic acid (leucovorin) -- if you are taking methotrexate

Support Groups:

Support groups with others who suffer from similar diseases may help patients and their families learn about their diseases and adjust to the changes associated with the treatment.

Expectations (prognosis):

Without treatment, patients can die within a few months.

With treatment, the outlook for most patients is good. Studies have shown that most patients who receive corticosteroids and cyclophosphamide get much better.

However, the disease may return in about half of all patients. In these cases, the disease usually comes back within 2 years of stopping treatment.

Complications:

Complications usually result from lack of treatment. Patients with Wegener's granulomatosis develop sores (lesions) in the respiratory tract and the kidneys. Kidney lesions cause glomerulonephritis, which may result in blood in the urine and kidney failure. Kidney disease can quickly get worse.

If untreated, kidney failure and death occur in more than 90% of patients.

Other complications may include:

  • Lung failure
  • Eye swelling
  • Nasal septum perforation (hole inside the nose)
  • Side effects from medicines used to treat the disease

Calling your health care provider:

Call your health care provider if chest pain, coughing up blood, blood in the urine, or other symptoms of this disorder are present.

  • Reviewed last on: 5/30/2007
  • Donald Accetta, MD, MPH, President, Allergy & Asthma Care, PC, Taunton, MA.Review provided by VeriMed Healthcare Network.

References

Murray J, Nadel J. Textbook of Respiratory Medicine. 3rd ed. Philadelphia, Pa: W.B. Saunders Company; 2000: 1462-1463.

Harris ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB. Kelley's Textbook of Rheumatology. 7th ed. St. Louis, Mo: WB Saunders; 2005:1361-1366.

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