Wegener's granulomatosis: Possible role of environmental agents in its pathogenesis.

To investigate the possibility that environmental agents contribute to the pathogenesis of Wegener's granulomatosis (WG). We undertook an extensive search for possible environmental exposures by developing a comprehensive questionnaire that was administered by telephone interview to 53 patients with WG and 2 control groups: one with osteoarthritis and the other with gout. Questions focused on hobbies and vocations, work, home, and allergies. Exact logistic regression was used to calculate odds ratios and 95% confidence intervals after adjusting for potential confounders. After adjusting for age and sex, data are reported for all exposures with odds ratios >2.0 against either control group or for any allergic propensity. Results suggest that mercury and perhaps lead exposure were positively associated with WG as compared with either control group, although the number of patients exposed was small. A prior history of allergy was also associated with WG as compared with either control group. We conclude that heavy metal exposure and a prior history of allergy may play a role in the etiopathogenesis of Wegener's granulomatosis.