Progress in rheumatology: understanding autoimmune disease.

Fifty years ago, Wegener's granulomatosis was a uniformly fatal condition; the diagnosis was usually made post-mortem. Today, many patients survive, with a 93% complete remission rate reported 4 years after diagnosis. Four medical advances over the past 50 years have enhanced our understanding and management of this rheumatologic disorder. They are a rational classification of the vasculitides, development of a diagnostically useful serologic assay, successful treatment with cyclophosphamide, and novel ideas as to etiology.