Diagnoses A-Z

Wegener's Granulomatosis Symptoms, Causes & Treatment Options

Learn about Wegener's granulomatosis, including symptoms, causes, treatment options, and when to seek consultation. Or take a quiz to get a second opinion on your Wegener's granulomatosis from our A.I. health assistant.

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. Questions Your Doctor May Ask
  7. References

What Is Wegener's Granulomatosis?

Summary

Wegener's granulomatosis, more recently re-named granulomatosis with polyangiitis, is a disorder in which a dysregulated immune system causes widespread inflammation of small blood vessels throughout the body. This results in slower or impaired blood flow to your nose, sinuses, throat, lungs, and kidneys [1,2].

Symptoms can be widespread and affect various parts of the body such as the eyes and ears or respiratory system, yet usually begin more generally with fever, fatigue, a loss of appetite, and weight loss. With treatment, a full recovery is possible; however, this condition can be fatal.

Treatments include immunosuppressive medications in order to control the disease in the short- and long-term.

Recommended care

You should visit your primary care physician soon to provide an early diagnosis. Treatment of inflammatory diseases commonly involve prescription medications such as a steroid to decrease inflammation, and a cell-damaging medicine to kill abnormal cells.

How common is Wegener's granulomatosis?

Rare

Wegener's granulomatosis is also known as

  • Wegener granulomatosis
  • Granulomatosis with polyangiitis

Wegener's Granulomatosis Symptoms

Because Wegener's granulomatosis is a systemic disease, it can cause a variety of symptoms. Furthermore, Wegener's granulomatosis can cause recurrent episodes with different sets of symptoms each time.

Main symptoms

Most people with Wegener's granulomatosis will develop a period of main, general symptoms that may last for weeks or months before more specific symptoms develop. This may include:

Nasal symptoms

Approximately 90 percent of people with Wegener's granulomatosis will develop some nasal symptoms, including [3]:

Ear symptoms

Many people can also develop ear symptoms, including:

Respiratory and chest symptoms

Lung and chest-related symptoms are likely with Wegener's granulomatosis. These can include:

Kidney symptoms

Kidney problems usually develop later in the course of the disease after the onset of other symptoms, and will appear as:

Skin symptoms

About one-half of people with this condition will develop skin symptoms in the form of various rashes, including [4]:

  • Purple-colored ulcers: A common type of skin rash is a purple discoloration with overlying ulcers, usually seen on the legs.
  • Itchy wheals (urticaria)
  • Red streaks
  • Hard bumps in the skin

Neurological symptoms

Some people with this condition can develop neurological symptoms, including:

Eye symptoms

Some people with this condition can develop eye symptoms, such as:

Wegener's Granulomatosis Causes

The specific cause of Wegener's granulomatosis is unclear but is thought to involve an initial inflammatory event that causes a dysregulated immune response. Wegener's granulomatosis commonly affects individuals who are elderly or white. Triggers for developing Wegener's granulomatosis include infection, exposure to a toxin, a reaction to certain medications, after developing a blood clot, or certain genetic variations.

Infectious causes

Infections can cause a systemic inflammatory response throughout the body and may trigger the development of Wegener's granulomatosis. Specifically, Staphylococcus aureus, a common skin bacteria, is believed to potentially cause Wegener's granulomatosis and the associated widespread inflammation.

Exposure to toxins

These can also include inhaled irritants, such as:

  • Silica: This is found in mining, sandblasting, and stonework.
  • Mercury
  • Lead

Medications

Taking certain medications have been reported to trigger the development of Wegener's granulomatosis. A few possible medications and the conditions they are used for include:

  • Hydralazine: For severely high blood pressure
  • The antibiotic minocycline: For acne
  • Propylthiouracil: For high thyroid levels
  • Allopurinol: For Gout
  • Rifampin: For tuberculosis

Developing a blood clot

Developing a blood clot can cause an inflammatory response in the body. They commonly develop in the leg and may be brought on by:

  • Being immobile for a period of time: For example, taking a long plane ride
  • Taking oral contraceptive pills (birth control pills)
  • Cancer

Genetic variations

Certain genetic variations have been associated with an increased risk of developing this condition. These include genetic variants of a group of molecules found on certain immune cells, which may be involved in the development of Wegener's granulomatosis.

Wegener's Granulomatosis Symptom Checker

Take a quiz to find out if your symptoms point to Wegener's granulomatosis

Treatment Options and Prevention

Wegener's granulomatosis is a serious condition that is usually treated aggressively with medications to suppress the immune system until the active disease resolves [5]. These medications are usually given in two phases: an initial "induction" phase and a subsequent "maintenance" phase.

"Induction" phase immunosuppressive medications

Most people with active Wegener's granulomatosis will be recommended to start with a course of "induction" immunosuppressive medications.

  • Potency: These are stronger medications that will help quickly control the active inflammation.
  • Duration: These medications are usually continued for three to six months.
  • Medication types: Usually, this will consist of a steroid medication such as methylprednisolone and/or prednisone in combination with another medication such as methotrexate, rituximab, or cyclophosphamide.

"Maintenance" phase immunosuppressive medications

After a period of induction phase medications, most people with Wegener's granulomatosis will be switched to a course of maintenance phase immunosuppressive medications. The goal of maintenance therapy is to prevent the disease from causing symptoms again.

  • Potency: These medications are generally less potent than the medications used during the induction phase, and thus may cause less long-term side effects.
  • Duration: Maintenance therapy is usually continued for one to two years, and may be continued indefinitely in people who have had many episodes of disease.
  • Medication types: Possible medication used for maintenance include methotrexate, rituximab, azathioprine (Imuran), or mycophenolate (Cellcept).

Additional treatment options

Some people with severe symptoms of Wegener's granulomatosis may benefit from a treatment called plasma exchange therapy or surgery to repair associated nasal deformities.

  • Plasma exchange therapy: In this treatment, your blood is removed and replaced with blood products from a healthy donor. This can help quickly remove pro-inflammatory substances in the blood and control the active disease.
  • Surgery to repair nasal deformities: People who develop nasal deformities such as the "saddle-nose deformity" may benefit from a surgery to repair the nose, which can help open up the nasal passages and result in a more normal-appearing nose.

When to Seek Further Consultation

If you develop any symptoms of Wegener's granulomatosis such as fever, nosebleeds, nasal ulcers, ear pain, shortness of breath, rash, or blood in the urine, you should go to your physician. Your physician can order laboratory and imaging studies to determine if you have Wegener's granulomatosis, and start you on the appropriate treatment.

Questions Your Doctor May Ask to Diagnose

To diagnose this condition, your doctor would likely ask about the following symptoms and risk factors.

  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Any fever today or during the last week?
  • Have you experienced any nausea?
  • Have you lost your appetite recently?
  • Do you have trouble sleeping?

The above questions are also covered by our A.I. Health Assistant.

Wegener's Granulomatosis Symptom Checker

Take a quiz to find out if your symptoms point to Wegener's granulomatosis

References

  1. Granulomatosis with polyangiitis. Mayo Clinic. Published August 8, 2017. Mayo Clinic Link
  2. Granulomatosis with polyangiitis (Wegener's). American College of Rheumatology. Updated May 2017. American College of Rheumatology Link
  3. Granulomatosis with polyangiitis. Genetic and Rare Diseases Information Center. GARD Link
  4. Granulomatosis with polyangiitis. National Organization of Rare Disorders. Published 2017. NORD Link
  5. Kubaisi B, Abu Samra K, Foster CS. Granulomatosis with polyangiitis (Wegener's disease): An updated review of ocular disease manifestations. Intractable Rare Dis Res. 2016;5(2):61-9. NCBI Link