Background: Wegener’s granulomatosis is characterized by necrotizing granulomatous lesions of the upper
respiratory tract, renal disease, and systemic vasculitis of small arteries and veins. The necrotising vasculitis, leading severe morbidity and mortality, has to be diagnosed and managed urgently.
Functional renal impairment is uncommon as initial presentation Involvement of gastrointestinal
system in Wegener’s granulomatosis is relatively rare and usually occurs long after the onset of initial symptoms.
Case Report: We report an unusual case of Wegener’s granulomatosis presented with acute renal failure and
gastric ulcer as the initial clinical manifestations.
Conclusions: The patients with WG may present with rare clinical manifestations such as acute renal failure and a gastrointestinal hemorrhage due to gastric ulcer. The fatal survey may be prevented firstly by early diagnosis, then by a careful and close clinical follow up.

Keywords: Wegener’s granulomatosis, acute renal failure, gastric ulcer