Graves' disease as the initial manifestation of wegener's granulomatosis: a case report

Wegener's granulomatosis is a necrotizing granulomatous vasculitis with the prevalence of 3 in 100000. Pulmonary involvement is the most common form of disease manifestation detected in 95% of cases but onset of disease with other symptoms such as proptosis and hyperthyroidism is very rare. Our patient was a 29-year-old man who had been presented to the hospital with goiter, palpitation, fatigue, and proptosis in 1997. He underwent subtotal thyroidectomy and was treated with methimazole. After six years of treatment, he admitted to the hospital for the second time with arthritis, arthralgia, fever, hematuria and nodular pulmonary lesions. Open lung biopsy confirmed the diagnosis of wegener's granulomatosis