Wegener's granulomatosis with cardiac involvement masquerading as Lyme disease

D.J. Kouba¹, D.G. Kirsch², D. Mimouni¹, C.H. Nousari¹

¹Department of Dermatology, Johns Hopkins University, Baltimore, Maryland; ²Department of Radiation Oncology, Massachusetts General Hospital, Boston, Masssachusetts, USA.

ABSTRACT
Cardiac conduction disease is an infrequent complication of Wegener's granulomatosis (WG). We describe a case demonstrating an association between WG and complete atrioventricular dissociation. This manifestation was initially interpreted as Lyme disease based on these cardiac findings, arthritis, myalgias and positive Lyme serology. The clinical overlap between these disorders and the appropriate use of respective serologies is discussed. 

Key words
Wegener's granulomatosis, Lyme disease, heart block, ANCA.

Please address correspondence to: Carlos H. Nousari, MD, Chairman, Department of Dermatology, Cleveland Clinic Florida, 2960 Cleveland Clinic Boulevard, Weston, Florida 33331, USA. 
E-mail: carlos.nousari@uphs.upenn.edu

Clin Exp Rheumatol 2003; 21: 647-649.
© Copyright Clinical and Experimental Rheumatology 2003.