*Renin-induced proteinuria*
In unilateral renal-artery stenosis

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Normal glomerulus
(Green arrows point to glomerular capillaries)

FSGS
Blue arrow: segmental sclerosis
Yellow arrow: normal glomerulus

Wegener's granulomatosis
Is an autoimmune disorder that results in inflammatory reactions, necrotizing vasculitis and granulomatous lesions in various tissues and organs of the body.

What parts of the body are affected by Wegener's?
Almost any part of the body can be affected. However, three sites are most typically involved: these are the upper airways - such as the ears, nose and sinuses; the lungs; and the kidneys.

In the case of the ears and
sinuses, the patient may complain of pain in these areas، deafness may also develop, bleeding from the nose (epistaxis) is also a very common event, lung involvement may be noticed by the haemoptysis and kidney inflammation by haematuria.

In addition to ESR, CRP, CBC and taking biopsy is there any specific blood test to make the dx?
Yes, a big breakthrough in diagnosing Wegener's was described in the 1980s, when it was found that a particular blood test was very useful in identifying patients with Wegener's.
This is called :ANCA (antineutrophil cytoplasmic antibodies) test.
This test is very accurate and can tell us very precisely what’s the diagnosis.

Pulmonary involvement
I’m not sure if this is a cavity*

Urine dipstick test
For detection of any protein or blood in urine when kidney is involved ( the classical pattern of disease)

Treatment:

- The steroid drugs:
prednisolone is the one most commonly employed.

- immunosuppressive drugs:
The most commonly used drugs are cyclophosphamide and azathioprine.

This study conducted at department of Otolaryngoogy Head and Neck Surgery Jinnah Hospital Lahore, during the period from December 1998 to July 2001.

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