A patient with Wegener's granulomatosis with initial clinical presentations of Henoch-Schonlein purpura

The initial presentation of a patient with Wegener's granulomatosis was ind istinguishable from that of Henoch-Schonlein purpura. The patient presented with skin purpura and pulmonary hemorrhage followed by purpura in the colo n. The diagnosis of this patient at that time was Henoch-Schonlein purpura. With time, massive lesions in the sinus and those with cavities in the lun g became apparent, and a specimen obtained from the sinus massive lesion wa s disclosed to be granulomatous inflammation. Retrospectively, the proteina se 3 antineutrophil cytoplasmic antibody turned out to be strongly positive in her stored serum from the time of the initial presentation.