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An unusual cause of death in Wegener’s granulomatosis
  1. E Suresh,
  2. D Wong,
  3. S Kamali,
  4. C Hall,
  5. R Luqmani
  1. Rheumatic Diseases Unit, Western General Hospital, Edinburgh, UK
  1. Correspondence to:
    Dr E Suresh
    Rheumatology Department, Kettering General Hospital, Rothwell Road, Kettering NN16 8UZ, UK; dr_esuresh{at}

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Mortality among patients with Wegener’s granulomatosis (WG) is more likely among those with renal disease.1,2 Among the non-renal causes, laryngeal involvement with airway obstruction is a rare but important preventable cause of death.3 Here, we describe a patient with WG and laryngeal involvement, in whom death occurred by inhalation of a nasal crust.

The patient, a 26 year old woman, first presented to us in 1998 with a 3 year history of intermittent stridor associated with hoarseness of voice, intermittent nasal stuffiness, nasal crusting, and recurrent sinusitis. Serum perinuclear antineutrophil cytoplasmic antibody was positive at a titre of 1/80 by indirect immunofluorescence, with myeloperoxidase-ANCA of 28 AU/ml (normal range 0–5) by enzyme linked immunosorbent assay (ELISA), while cytoplasmic ANCA was negative and proteinase 3-ANCA …

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