Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Wegener's granulomatosis is a uncommon type of inflammation of
small
arteries and veins (vasculitis). It classically involves
inflammation of
the arteries that supply blood to the tissues of the lungs, the
nasal
passages
(sinuses), and the kidneys. "Incomplete" forms exist
that only
involve one of these areas. When both lungs and kidneys are affected, the condition is sometimes referred to as generalized Wegener's granulomatosis. When only the lungs are involved, the condition is sometimes referred to as limited Wegener's granulomatosis.
Wegener's granulomatosis usually
affects young
or middle-aged adults. Although it is uncommon in children, it
can affect people at any age. The cause of Wegener's granulomatosis
is not known.
What are symptoms of Wegener's granulomatosis?
Symptoms of Wegener's granulomatosis include fatigue, weight
loss,
fevers, shortness of breath, bloody sputum, joint pains, and
sinus
inflammation (sinusitis). Nasal ulcerations and even bloody
nasal discharge
can occur. Other areas of the body that can also become
inflamed in
patients with Wegener's granulomatosis include the eyes, the
nerves
(neuropathy), the middle ear (otitis media), and the skin resulting in skin nodules or ulcers.
How is Wegener's granulomatosis diagnosed?
Abnormal lab findings in patients with Wegener's
granulomatosis include
urine tests that detect protein and red blood cells in the
urine (not
visible to the naked eye) and x-ray tests of the chest and
sinuses which
detect abnormalities resulting from lung and sinus
inflammation. Blood
tests that detect the abnormal inflammation include the
sedimentation rate (sed rate) and
C-reactive
protein. A more specific blood test
used to
diagnose and monitor Wegener's granulomatosis is the
antineutrophil
cytoplasmic antibody (ANCA test), which is commonly elevated when the disease is active.
The diagnosis of Wegener's granulomatosis
is
confirmed by detecting both abnormal cellular formations, called
granulomas, and vasculitis in a biopsy of tissue involved
with the
inflammatory process. For examples, an open lung biopsy or a kidney biopsy are commonly used in making a diagnosis of Wegener's granulomatosis.
Sinus infection (sinusitis) signs and symptoms include headache, fever, and facial tenderness, pressure, or pain. Treatments of sinus infections are generally with antibiotics and at times, home remedies.
Vasculitis is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.
Relapsing polychondritis is an uncommon, chronic disorder of the cartilage that is characterized by recurrent episodes of inflammation of the cartilage of various tissues of the body. Tissues containing cartilage that can become inflamed include the ears, nose, joints, spine, and windpipe (trachea). Tissues that have a biochemical makeup similar to that of cartilage such as the eyes, heart, and blood vessels, can also be affected. Nonsteroidal antiinflammatory medications (NSAIDs) is used as treatment for mild cases of the disease. Steroid-related medications also are usually required.
You have been informed by your healthcare provider that you will need to
receive intravenous (IV) infusions of a medication to treat your health condition.
What are some of the conditions that are treated with an IV drug infusion?
Examples of conditions treated with IV infusion include:
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