Bronchocentric granulomatosis, acute renal failure, and high titer antineutrophil cytoplasmic antibodies: possible variants of Wegener's granulomatosis

Abstract

We describe 2 patients with clinical syndromes suggestive of Wegener's granulomatosis: elevated titers of cytoplasmic antineutrophil cytoplasmic antibodies (cANCA), bronchocentric granulomatosis, and acute renal failure. A renal biopsy in one case showed crescentic glomerulonephritis and in the other case showed interstitial nephritis. These cases may reflect bronchocentric granulomatosis among a spectrum of diseases associated with cANCA. Use of cANCA may identify those patients with bronchocentric granulomatosis who require immunosuppressive therapy.