Dacryoadenitis as the Earliest Presenting Manifestation of Systemic Wegener's Granulomatosis

Abstract

Purpose To report a case presenting with dacryoadenitis as the earliest manifestation of systemic Wegener's granulomatosis (WG). Design Observational case report. Methods A 41-year-old woman initially presented symptoms of bilateral dacryoadenitis. She subsequently developed upper and lower respiratory tract involvement, scleritis and keratitis. Results Cytoplasmic antineutrophil antibody (c-ANCA) titer was positive. The lacrimal gland and lung biopsies were consistent with WG. The patient responded well to cyclophosphamide and prednisolone. Conclusions Dacryoadenitis may be the earliest presenting manifestation of WG and prompt immunosuppressive chemotherapy may control it preventing the limited disease from progressing to a complete form and reducing its morbidity and mortality