To the Editor.—We were intrigued and gratified to read another article on Wegener's granulomatosis in which a favorable response to treatment with sulfamethoxazole and trimethoprim was documented.1 That patient is unusual among the small number of similar reports for not having received cyclophosphamide treatment. Since the text and Fig 11 do not permit their assessment, we would be interested in learning the extent of the vasculitis in the biopsy specimen, and whether or not acid-fast, periodic acid–Schiff, and various silver stains were performed.
Elsewhere, we documented a complete and sustained remission in Wegener's granulomatosis with sulfamethoxazole and trimethoprim treatment.2 Because of the limited reference to our observations in the recent article, which reads "... a single case was reported of a patient with Wegener's granulomatosis treated unsuccessfully with steroids and cyclophosphamide who seemed to respond coincidentally with the use of sulfamethoxazole-trimethoprim,1" please allow us to reiterate
KING JW, TODD JR, WEST BC. Wegener's Granulomatosis. Arch Intern Med. 1989;149(7):1695–1698. doi:10.1001/archinte.1989.00390070193038
Customize your JAMA Network experience by selecting one or more topics from the list below.