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Asymptomatic splenic infarction in Wegener's granulomatosis
  1. D Papaioannides1,
  2. S N Nikas1,
  3. M Fotinou2,
  4. N K Akritidis3
  1. 1Department of Medicine, Arta General Hospital, Arta, Greece
  2. 2Department of Pathology, “Sotiria” Hospital for Chest Diseases, Athens, Greece
  3. 3Department of Medicine, “Hatzikosta” General Hospital, Ioannina, Greece
  1. Correspondence to:
    Dr D Papaioannides, PO Box 92, 47100 Arta, Greece;
    gnna{at}art.forthnet.gr

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Wegener's granulomatosis (WG) is a necrotising, granulomatous vasculitis that classically involves the clinicopathological triad of upper and lower respiratory tracts and the kidney.1 Less frequently, the disease may affect other organs as well. Serious and occasionally fatal complications within the spleen occur in many autoimmune rheumatic diseases,2 and prompt recognition of these complications is important. In a necropsy series of patients with WG, the spleen was commonly affected: 78–100% of patients had splenic lesions with a combination of necrosis, vasculitis, and granuloma formation.3,4 Clinically apparent splenic disease is rare, however.1 We wish to report briefly the case of a 47 year old woman who presented with manifestations of classical WG and radiological evidence of splenic infarcts.

Case report

A 47 year old woman during the past month developed fevers to 38.6°C associated with weight loss, diffuse arthralgias, anaemia, and erythrocyte sedimentation rate of more than 100 mm/1st h. During the past three months she complained of nasal congestion …

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