Pleural effusions in Wegener's granulomatosis: report of five patients and a brief review of the literature.

Wegener's granulomatosis (WG) is an uncommon disease of unknown aetiology which is characterised histologically by a necrotising granulomatous angiitis. The airway, lungs and the kidneys are predominantly involved, but the disease has been documented to affect virtually every organ system. The clinical course is variable and ranges from a short, rapidly fatal illness at one end of the spectrum to indolent involvement compatible with several years of survival at the other. A majority of patients have pulmonary disease evidenced clinically by cough, sputum production and haemoptysis and radiologically by infiltrates, nodules and cavitation. Pleural effusions, however, are rare. No detailed information regarding the nature and clinical behaviour of these effusions is available and only a recent French study has listed the nature of the fluid in passing. We have observed pleural effusions in five patients with WG who are the basis of this report.