[The importance of an early diagnosis: about a case of Wegener's granulomatosis]

We report a case of a young man with Wegener's granulomatosis. Initial clinical features were constitutional symptoms and nasal sinus involvement. Those manifestations were not correctly understood during four years, based on the lack of pathological findings. It was only when nephrotic syndrome was present, apparently after a three to four years renal involvement that diagnosis was found, supported upon renal biopsy, the presence of serum antineutrophil cytoplasm antibodies (ANCA) and revision of initial pathological specimen from sinus surgery. For many reasons it was not possible to make a correct diagnosis on time to prevent permanent renal failure and facial destroying lesions. The natural history of this clinical case emphasizes the need of an early and correct diagnosis, to prevent serious consequences of a severe illness.