Wegener's granulomatosis presenting as multiple bilateral renal masses

Wegener’s granulomatosis (WG) is a systemic disease characterized pathologically by necrotizing granulomatous inflammation of the respiratory tract and generalized vasculitis involving mediumand smallsized vessels. Kidney involvement is usually manifested as a focal segmental necrotizing glomerulonephritis, with crescents [1]. Anti-neutrophil cytoplasm antibody (ANCA) testing has provided a very useful diagnostic aid. The majority of patients with WG have antibodies towards proteinase 3 (PR3-ANCA) (>70%), but antibodies towards myeloperoxidase (MPO-ANCA) is seen in 20% of cases. A few patients (