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Rare manifestations of Wegener's granulomatosis To the Editor: Wegener' s granulomat t tosis (WG) is a necrotizing granulot t matous smalltvessel vasculitis. 1 The frequency of cardiac involvement in WG varies from 6 to 12 percent. 2 However, the occurrence of ascites and hemorrhagic effusion in WG were not reported in a MEDLINE search. A 19tyeartold man was referred to Baqyatollah hospital with a hist t tory of fever and polyarthritis for two weeks. The patient presented with weight loss, productive cough, and hemoptysis. His temperature was 39ºC, heart rate 95/min and the respiratory rate was 28/min. A diffuse, coarse crackle was audible over both lungs. Severe joint inflamt t mation was noted. His chest Xtray showed multiple pulmonary infilt t tration (Figure 1). He was treated for pulmonary abscess with clindat t mycin and ceftriaxone. The fever subsided gradually, but the polyart t thritis, tachycardia, and tachypnea