[A case of limited form of Wegener's granulomatosis without detection of anti-neutrophil cytoplasmic antibody].

A 52-year-old woman was admitted to our hospital because of high fever and productive cough. Her chest X-ray showed multiple cavitary nodules in both lungs. Although we suspected Wegner's granulomatosis (WG), anti-neutrophil cytoplasmic antibody (ANCA) was not detected in her serum. Finally, an open lung biopsy was performed, and the limited form of Wegener's granulomatosis was diagnosed. With cyclophosphamide and steroid treatment, she markedly improved. We conclude that in patients suspected of having WG, it is necessary to perform open lung biopsy regardless of the detection of ANCA.