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A 50 year old man, affected by a Wegener's granulomatosis limited to lung, is presented. The indirect immunofluorescence test for "Anticytoplasmic Antibodies" (ACPA) was negative and we got the definitive diagnostic by the histological study from thoracotomy and biopsy samples. We started treatment with trimethoprim-sulfamethoxazole and a good evolution with an adequate clinical control, x-ray study and blood test was obtained. Some aspects of the value of the ACPA as diagnostic and activity markers of the disease and also the use of an antimicrobial agent on the treatment of this nosological entity are discussed.
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