Poststreptococcal glomerulonephritis and nasal symptoms: Wegener's granulomatosis

The clinical course and laboratory findings initially strongly suggested the presence of acute poststreptococcal glomerulonephritis in a 15-year-old boy. However, during the search for the origin of the infection, the otorhinolaryngological examination revealed mucosal abnormalities of the nose and paranasal sinuses, which, together with the histopathology of the renal biopsy and the presence of antineutrophilic cytoplasmic antibodies in the serum, were consistent with Wegener's granulomatosis. The differential diagnostic process and the difficulties encountered in the management of the case are presented.Wegener's granulomatosis is not a common diagnosis in children, and may easily be overlooked in young patients, being misinterpreted as an infectious disease of the respiratory tract followed by acute poststreptococcal glomerulonephritis.