A Case of Subglottic Granuloma Formation in Wegener's Granulomatosis

While following the course of patients with Wegener's granulomatosis in which it had been possible to achieve a remission, we encountered a patient in whom we observed granuloma formation in the subglottis. A tracheostomy was performed because of the risk of respiratory distress, and after that there was a recrudescence of the patient's Wegener's granulomatosis. During the course of the above, the patient remained ANCA (Anti-neutrophil cytoplasm antibody) -negative. When these facts were considered, it appeared that when the lesions are localized and progressing gradually, ANCA positivity dose not develop. Moreover, when we take into consideration the fact that the initial onset was after surgery, the surgery may also have been an etiologic facter.