Focal Segmental Glomerulosclerosis as the Sole Renal Lesion in Wegener’s Granulomatosis

Wegener’s granulomatosis usually presents with focal necrotizing glomerulonephritis with crescents. We present here a 45-year-old man who was treated for tuberculosis and later presented with bilateral ankle swelling. His serum creatinine was 2.4 mg/dL and urine analysis revealed hematuria and proteinuria. His 24-hour urine protein excretion was 1.9 g. Anti neutrophil cytoplasmic antibodies (ANCA) test was positive with cytoplasmic florescence pattern. Renal biopsy revealed focal segmental sclerosis with no active vasculitis and lung biopsy revealed extensive breakdown with cavitations and scattered granulomas.