Article
Isolated Morbus Wegener of the middle ear – Diagnostic challenge
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Authors
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Georgi Kukushev
- Military Medical Academy - Sofia, Sofia, Bulgarien
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Ventzislav Tzvetkov
- Military Medical Academy - Sofia, Sofia, Bulgarien
| Published: | March 30, 2016 |
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Outline
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Introduction: Morbus Wegener is a necrotic vaskulitis that involves the small and middle large vessels with ulcerative granulomes of the respiratory tract (nose and paranasal cavities, middle ear, oropharynx, lungs) and the kidney (in about 80%).
It is uncommon disease (about 5/100 000).
The early diagnosis and treatment is very important for the late prognosis of this disease.
Methods: We would like to present two cases of Morbus Wegener in first (local) stage. In both cases the clinical presence was otitis media with acute mastoiditis, peripheral facial palsy and severe headache, but completely different laboratory and histological results.
The diagnosis Morbus Wegener is made according to the criteria of the Rheumatology Guidelines. However none of both patients had fulfilled the criteria for this disease.
On the other hand the treatment of Morbus Wegener has various side effects and the “ex juvantbus” therapy is a hard decision.
Results: Both cases were first (local) stage isolated Morbus Wegener of the middle ear. After the rheumatological treatment the patients are in continuous remission.
Conclusions: We would like to remind with this presentation the clinical diversity of Morbus Wegener because sometimes even with no sure proof the “ex juvantbus” therapy could save the intracranial complication and put the patient in continuous remission with no systemic manifestation of the disease.
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