[Guillain-Barré polyneuropathy in Wegener's granulomatosis with pulmonary-renal syndrome].

A 49-year-old female patient suffering from severe necrotising respiratory granulomatosis (Wegener's granulomatosis) had acute renal failure, nearly uncontrollable haemoptyses and severe deterioration of pulmonary function. Haemodialysis had to be performed; immuno-suppressive therapy was effected by administration of high doses of methylprednisolone (100-500 mg/d) and cyclophosphamide (initially with single doses of 500-1000 mg) and plasmaphereses. Artificial ventilation by positive-negative pressure breathing became necessary because pulmonary function became consistently poorer. Glucocorticoid therapy led to the development of several duodenal ulcers resulting in profuse gastrointestinal bleedings requiring transfusions; on the whole, 20 erythrocyte concentrates had to be substituted. These transfusions, in turn, caused a non-A, non-B hepatitis. In the further course of the illness, a Guillain-Barré polyneuropathy developed. Biopsy and electrophysiological tests excluded granulomatous involvement of the nerves as a cause of the latter. But it is likely that there was a pathogenetic connection between the hepatitis and the polyneuropathy.