Generalized Wegener's granulomatosis responding to sulfamethoxazole-trimethoprim monotherapy

Intern Med. 2001 Jul;40(7):666-70. doi: 10.2169/internalmedicine.40.666.

Abstract

Wegener's granulomatosis (WG) has two different clinical phases: the initial phase and generalized phase. In patients with generalized WG, both steroids and cyclophosphamide have generally been used. We report a case of generalized WG that was temporarily, but successfully treated with sulfamethoxazole-trimethoprim (S/T) alone. S/T therapy reduced the elevated levels of soluble IL-2 receptor and IL-6 in parallel with improvement of the patient's symptoms and urinary protein excretion. In view of the high incidence of lethal adverse effects of cytotoxic drugs, S/T monotherapy may be worth trying not only for initial phase WG but also for generalized WG with careful follow-up when the patient is not acutely ill.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Infective Agents / therapeutic use*
  • Cytokines / blood
  • Drug Combinations
  • Female
  • Granulomatosis with Polyangiitis / blood
  • Granulomatosis with Polyangiitis / drug therapy*
  • Humans
  • Remission Induction
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use*

Substances

  • Anti-Infective Agents
  • Cytokines
  • Drug Combinations
  • Trimethoprim, Sulfamethoxazole Drug Combination