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The initial presentation of a patient with Wegener's granulomatosis was indistinguishable from that of Henoch-Schonlein purpura. The patient presented with skin purpura and pulmonary hemorrhage followed by purpura in the colon. The diagnosis of this patient at that time was Henoch-Schonlein purpura. With time, massive lesions in the sinus and those with cavities in the lung became apparent, and a specimen obtained from the sinus massive lesion was disclosed to be granulomatous inflammation.doi:10.2169/internalmedicine.40.1050 fatcat:htzvfeid3bdh5iqgjg54jg37p4