Respiratory granulomatosis with polyarteritis nodosa (Wegener's syndrome).

In 1931 Klinger published a case of nasal sinusitis which terminated in renal failure. There have since been a number of reports of a syndrome characterized clinically by a combination of intractable rhinitis or pulmonary symptoms, manifestat.ons of polyarteritis nodosa, and renal failure. Pathologically, the disease is recognized by the association of necrotizing granulomata of the respiratory tract and generalized arteritis with focal glomerulitis. The syndrome has been known as Wegener's granulomatosis since his detailed description of three cases in 1936 and 1939. In 1954 Fahey, Leonard, Churg, and Godman collected 22 cases from the literature and added seven of their own. The pathological features of these 29 cases were analysed by Godman and Churg (1954). Since this review six more have been reported by McCallum (1954), Seidelin and Willcox (1954), Milner (1955), and Walton and Leggat (1956). We present two further cases of this syndrome. Each presented a difficult problem in the diagnosis of a respiratory illness.