GODMAN and Churg, in 1954, wrote a comprehensive article on Wegener's granulomatosis. About the time this appeared we were puzzling over an unusual case, the history of which is reported here.
A 42-year-old Hawaiian-Caucasian woman was admitted to the hospital for the second time on Oct. 18, 1954, with a chief complaint of intermittent pains in the costovertebral angles bilaterally, but more pronounced on the right, following a subtotal gastrectomy eight months previously. She also complained of nocturia and of diurinal frequency. A 37 lb. weight loss was noted during this time. Ankle edema and exertional dyspnea had been present intermittently.
The patient had had a "sinus" cough for many years. Two years preceding the present hospitalization, she had an attack of pneumonia. Six months later she was first hospitalized for a benign chronic gastric ulcer, which was resected. Subsequently, a gastroenterostomy was performed. Concurrently, she developed hepatitis. Postoperatively she