Control of a relapse and induction of long-term remission of Wegener's granulomatosis by cyclosporine.

We report a case of severe Wegener's granulomatosis that caused end-stage renal failure and recurrent flares of sinusitis and pulmonary manifestations. To avoid the cumulative toxicity of iterative treatments with cyclophosphamide pulses and glucocorticoids, treatment with cyclosporine as a single agent was instituted in the early phase of the third relapse, before any pulmonary involvement. Cyclosporine enabled rapid control of the disease and induced a complete remission of more than 30 months.