Q: My sister is suffering from Wegener's granulomatosis (WG) from the last 3 years. She has undergone chemotherapy and has to take strong steroids everyday to curb the illness. However, the treatment only work for short periods and her condition fluctuates from good to bad to worse after the treatment wears off. Her WG is confined to the nasal area and has not spread to her major organs. Is there any treatment for the same in India? I have noticed that this is extremely rare, especially in Asians. We already know of 3 Indians locally who suffer from this same illness. Is this just a coincidence or is there something more to it? Apparently it only strikes around 1 in a million!

A:Wegener's granulomatosis is a disease that even he does not know how to treat. It is in the crossover zone of a malignancy and anautoimmune disorder or it may be caused by an infection interacting with a collagen vascular disease. It is not all that rare and indeed it is curious that it is not a more frequent finding in AIDS. Some studies suggest it may improve with sulphonamides but this is hard to gauge since it may even improve markedly with the standard steroid and immunosuppressive agents of routine standard therapy regimens. Maybe one of the currently unavailable drugs will prove to be effective, hopefully in time to help those with this disorder.