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Clinical use of cyclophosphamide (CYC) improves the prognosis of Wegener's granulomatosis (WG),1 ,2 though treatment related malignancies have been recorded.3-5 Among treatment related malignancies, the development of erythroleukaemia has been rarely reported.6 In addition, there have been no reports of erythroleukaemia arising in patients with WG.
A 59 year old woman presented with nasal bleeding, nasal obstruction, and fever in December 1994. A biopsy specimen from nasal mucosa was compatible with WG, and cytoplasmic antineutrophil cytoplasmic antibodies (cANCA) were 13 EU (normally undetectable). A chestx ray examination on admission showed the presence of a cavity in the right lung field. She received 30 mg/day of prednisolone, with limited improvements. CYC (100 mg/day) was therefore given orally from 19 December. As …