[Cotrimoxazole in the treatment of Wegener's vasculitis (case report)].

A female patient suffering from Wegener's vasculitis of upper respiratory tract, lungs, kidney and skin, is presented. The diagnosis has been established on the basis of clinical course, histopathologic examination of lung tissue obtained by transbronchial lung biopsy and positive serum antineutrophil cytoplasmatic antibodies (ANCA). The patient was successfully treated with trimethoprim-sulfamethoxasole (daily dose 320 + 1600 mg) leading to complete clinical remission. The course of disease and the effects of treatment were strongly drug-dose-related. We emphasized some diagnostic difficulties and new trends in the therapy of Wegener's granulomatosis and other ANCA positive vasculitides. Possible mechanisms of the trimethoprim-sulfamethoxasole efficiency in Wegener's granulomatosis are also discussed.