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A diagnostic dilemma: differentiating between granulomatosis with polyangiitis and tuberculosis

Farrouq S Mahmood, Edward Schwatz, Shinoy Kurrup, Charles Sharp, Georgina Hands and Alison Moody
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DOI: https://doi.org/10.7861/clinmedicine.13-4-411
Clin Med August 2013
Farrouq S Mahmood
North Devon District Hospital, Barnstaple, UK
Roles: core medical trainee year 2
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  • For correspondence: farrouqmahmood@doctors.org.uk
Edward Schwatz
North Devon District Hospital, Barnstaple, UK
Roles: foundation year 1
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Shinoy Kurrup
North Devon District Hospital, Barnstaple, UK
Roles: core medical trainee year 3
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Charles Sharp
North Devon District Hospital, Barnstaple, UK
Roles: specialist registrar
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Georgina Hands
North Devon District Hospital, Barnstaple, UK
Roles: consultant in respiratory medicine
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Alison Moody
North Devon District Hospital, Barnstaple, UK
Roles: consultant in respiratory medicine
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Figures

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    Fig 1.

    Chest X-ray showing numerous bilateral ill-defined nodular opacities.

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    Fig 2.

    Histology slide showing multi-nucleate giant cells taken from patient's nasal biopsy.

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    Fig 3.

    HRCT slice in which ill-defined opacities and possible early cavitation can be seen. HRCT = high resolution computed tomography.

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    Fig 4.

    CRP of the patient during the course of admission. Five plasma exchanges were given over 5 consecutive days the patient stayed in ITU. The patient was transferred to ITU on day 17, and plasma exchange was started. CRP = C-reactive protein. ITU = intensive care unit.

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A diagnostic dilemma: differentiating between granulomatosis with polyangiitis and tuberculosis
Farrouq S Mahmood, Edward Schwatz, Shinoy Kurrup, Charles Sharp, Georgina Hands, Alison Moody
Clinical Medicine Aug 2013, 13 (4) 411-413; DOI: 10.7861/clinmedicine.13-4-411

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A diagnostic dilemma: differentiating between granulomatosis with polyangiitis and tuberculosis
Farrouq S Mahmood, Edward Schwatz, Shinoy Kurrup, Charles Sharp, Georgina Hands, Alison Moody
Clinical Medicine Aug 2013, 13 (4) 411-413; DOI: 10.7861/clinmedicine.13-4-411
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