Early symptoms may include fatigue, malaise (an ill feeling), fever, and a sense of discomfort around the nose and sinuses. Upper respiratory infections such as sinusitis or ear infections frequently precede the diagnosis of Wegener's Granulomatosis. Other upper respiratory symptoms include nose bleeds, pain, and sores around the opening of the nose.

Persistent fever without an obvious cause (fever of undetermined origin -- FUO) may be an initial symptom. Night sweats may accompany the fever. Loss of appetite and weight loss are common. Skin lesions are common, but there is no one characteristic lesion associated with the disease.

Kidney disease is necessary to make the definitive diagnosis of Wegener's Granulomatosis. The urine may be bloody, which often first appears as red or smoky urine. There may be no symptoms, but is easily diagnosed with laboratory studies.

Eye problems develop in a significant number of patients and may range from a mild conjunctivitis to severe inflammation of the eyeball and the tissues around the eyeball. Additional symptoms include:

• weakness
• loss of appetite
• weight loss
• bloody discharge from the nose
• pain over the sinuses
• sinusitis
• lesions (ulcers, sores, and crusting) in and around opening of the nose
• cough
• coughing up blood
• bloody sputum
• shortness of breath
• wheezing
• chest pain
• blood in the urine
• rashes
• joint pains

• biopsy of abnormal tissue, which may include:
  • open lung biopsy
  • upper airway biopsy
  • nasal mucosal biopsy
  • bronchoscopy with transtracheal biopsy
  • kidney biopsy
• urinalysis, protein and blood in the urine (proteinuria and hematuria)
• chest X-ray (cavity formation, pulmonary infiltrates)
• bone marrow aspiration (may be done)
• blood tests to look for the presence of autoantibodies (antibodies that the body makes against its own tissue)