Complete Heart Block due to Limited Wegener＊s Granulomatosis: A Case Report

作者：SA Jahed; M Zabihiyeganeh

来源：Iranian Cardiovascular Research Journal, 2011.

Complete heart block is a rare manifestation of various cardiac involvementsseen in Wegener＊s granulomatosis. To our knowledge there have only been twoprevious cases of complete heart block reported in patients with limited form ofWegener＊s granulomatosis in English literature. We describe a 62-year-oldIranian woman presenting with complete heart block who was candidate forpacemaker installation. Limited Wegener＊s granulomatosis was suspected becauseof bloody nasal discharge, fatigue, fever, arthralgia, dacrocystitis, andhistory of recurrent subglutic stenosis, but no renal involvement. The diagnosiswas subsequently confirmed by presence of granuloma in nasal mucosal biopsy andalso high level of serum anti-proteinase 3. Prednisolone and cyclophosphamidetherapy were initiated and her electrocardiography returned to normal sinusrhythm without any pacemaker installation. Awareness of unusual presentation ofWegener＊s granulomatosis is important in proper diagnosis and management of thepotentially fatal cardiac involvement of the disease. Complete heart block maybe reversed by appropriate medical therapy of Wegener＊s granulomatosis.