WEGENERS GRANULOMATOSIS PRESENTING AS A TEMPORAL HEADACHE

Formerly a fatal condition. Wegener's granulomatosis is now treated wi th good results. Clinical morbidity is often due to failure by clinici ans to make the diagnosis. Many patients (including our cases reported here) present with atypical symptoms, and only a high index of suspic ion will ensure early diagnosis. Classical chest and renal symptoms of ten indicate late stage disease. We present two cases that underline t he limitations of current 'diagnostic' immunological tests whilst emph asising the importance of clinical features in diagnosis. Standard tre atment with Cytotoxic agents and corticosteroids are effective but car ry considerable morbidity. We have followed the current trend of incor porating a less toxic antibiotic agent in the management of this enigm atic condition.