Wegener's granulomatosis associated with antiphospholipid syndrome

We report a case of Wegener's granulomatosis (WG) with pulmonary hemorrhage also satisfying the criteria for antiphospholipid antibody syndrome (APS). This association has, to the best of our knowledge, never been described be fore. Pulmonary hemorrhage may be an early manifestation of several immune and id iopathic disorders such as ANCA-associated vasculitis. Several case-reports of APS patients with capillaritis have been described. A possible explanat ion is that microvascular thrombosis with subsequent increase in vascular p ermeability facilitates perivascular IgG and complement deposition leading to development of capillaritis. Whether the vascular disease is secondary t o thrombosis or vasculitis or both is important in choosing the proper mana gement strategy. We suggest that anticardiolipin antibodies (aCL) should be detected in ANCA-associated vascularitis because they may contribute to li fe-threatening events superimposed on vascular damage.