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Wegener's granulomatosis Is Well Known For Its pulmonary symptoms (WG). however, there hasn't been any mention of a pleural effusion as a first symptom. Here We present a case of pleural effusion which is later diagnosed as Wegener’s granulomatosis. A 50-year-old male presented with pleuritic chest pain, CT Chest revealed pleural thickening and nodule, on examination there was palpable nodule on right side of chest. Pleural biopsy and lung biopsy showed thick chronic inflammatory infiltration in pleural biopsy and necrotizing granulomatous vasculitis. Laboratory investigations are positive for Wegener’s granulomatosis and patient is started on cyclophosphamide and methylprednisolone, for which he showed improvement.
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