Keywords: Wegener's granulomatosis, nose, early diagnosis

Abstract: Wegener's Granulomatosis (WG) is a system vasculitis characterized by granulomatosis inflammation and involvement of the upper and lower respiratory and the renal systems. The authors evaluate the nasal involvement on the WG for early diagnosis through nasal biopsy. This paper reports a case of a 48-year-old woman with repetition sinusitis. She was admitted in a hospital for surgery and the mucosal biopsy revealed chronic inflammatory pattern with granulomatous and necrotizing features. WG was the diagnosis. The initial treatment was made with prednisone and sulfamethoxazole-trimethoprim, but the systemic involvement and the aggressive course of the disease made necessary the introducing of cyclophosphamide. The upper respiratory system manifestations in WG may be as high as 90%. As the nasal mucosa is frequently involved and is also an easily accessible site in WG, nasal bi-opsy should be performed by the rhinologist as a method of choice in the diagnosis. With an earlier diagnosis, more aggressive tests would be avoided and the right therapy would have a better prognosis.