Hémorragies intra-alvéolaires de la granulomatose de Wegener. Etude rétrospective de 9 cas.

Among 66 patients with Wegener's granulomatosis, 9 had an intra-alveolar haemorrhage which revealed the disease. The diagnosis was based on dyspnoea (n=9), haemoptysis (n=9) and anaemia (n=9) with a mean haemoglobin level of 8±1 g/dl. Radiology showed bilateral alveolar infiltrates (n=9), and numerous siderophages were found either in the alveolar lavage fluid (n=7/7) or in sputum (n=2). In every case, the alveolar haemorrhage was accompanied by a rapidly progressive extracapillary glomerulonephritis and by lesions of the upper airways which preceded it by several months or years. All patients received corticosteroids combined, in 8 cases, with cyclosphosphamide. The respiratory disease improved rapidly, in contrast with the renal disease which became worse (n=5)