Relationship of lethal midline granuloma to Wegener's granulomatosis

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Abstract
Lethal midline granuloma (LMC) may remain localized or eventuate in systemic granulomatosis. In a search for predictive features, 10 patients with localized LMC were observed up to 9 years. Granuloma remained local in 5 and became systemic in 5. Friedmann's histologic criteria for distinction were not predictive. Polyarthralgia, cutaneous vasculitis, proteinuria, azotemia, leukocytosis, and rheumatoid factor developed in the patients in whom systemic granulomatosis ensued. Such findings in localized LMC suggest possible future Wegener's granulomatosis.

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