ELEVATED ANTINEUTROPHIL CYTOPLASMIC ANTIBODY TITER IN A PATIENT WITH ATYPICAL ORBITAL PSEUDOTUMOR

We recently examined a patient with ophthalmic manifestations of Wegen er's granulomatosis in whom antineutrophil cytoplasmic antibody (cANCA ) titers provided helpful diagnostic information. A 40-year-old man wh o had suffered from bilateral exophthalmos for 9 months was diagnosed initially as having idiopathic inflammatory pseudotumor. The patient e xhibited purulent nasal discharge charge and microhematuria. A histopa thologic study revealed vasculitis. His ANCA titer for cANCA was found to be evaluated, and our patient was subsequently diagnosed as having Wegener's granulomatosis. His ocular symptoms resolved and did not re cur after treatment with corticosteroid in combination with cyclophosp hamide. We believe that cANCA levels should be investigated in patient s with orbital pseudotumor as a possible sign of Wegener's granulomato sis.