However, in the final analysis a name is useful only if it is usable and used. No matter how logical and appropriate
a name may be based on contemporary knowledge of a disease, if it is not usable and used it is of no lasting value. In this brief commentary, as a case in point, I will focus on Wegener’s granulomatosis (WG), recently renamed ‘granulomatosis with polyangiitis’ (GPA) [1,2]. In spring 2011, just prior to the Fifteenth International Vasculitis and ANCA Workshop, the deliberations of a diverse group of clinicians and scientists will EPZ-6438 chemical structure result in modifications of the Chapel Hill Consensus Conference (CHCC) nomenclature for systemic vasculitides, which will be based on clinical, pathophysiological and ethical developments since the original CHCC in 1993. The goals of
the CHCC were to reach consensus on the names for some of the most common forms of systemic vasculitis and to construct root definitions for these [3]. The success of this effort is evidenced by its wide adoption in both clinical and research settings, and by greater than 17 000 citations in the medical literature. An impact of the recommendations of the CHCC is illustrated Birinapant clinical trial in Fig. 1, which shows the use of the diagnostic terms ‘microscopic polyarteritis’versus‘microscopic polyangiitis’ in the titles of papers published in the medical literature before and after the recommendation of the CHCC to use the latter term. One of the modifications that is anticipated in the 2011 CHCC nomenclature is a recommended nearly change from the diagnostic term ‘Wegner’s granulomatosis’ to ‘granulomatosis with polyangiitis’ (GPA), which has already been advocated by some of the 2011 CHCC participants [1,2]. This is justified both on the general rule that diagnostic terms with eponyms are less effective than more descriptive terms that refer to one or more distinctive features of a disease and, in the specific instance of Wegener’s granulomatosis, on the evidence that Dr Friedrich
Wegener was a member of the Nazi party before and during World War II [4]. The history of the naming of GPA (WG) is illustrative of how a name can influence the understanding of a disease. Instead of ‘rhinogenic granulomatosis’[5], what if Wegener had used the term ‘rhinogenic purulosis’, emphasizing the intense purulent inflammation that is much more conspicuous than true granulomatous inflammation in most acute respiratory tract lesions of GPA (WG) (Fig. 1)? [6,7] Would this emphasis on neutrophilic inflammation in the name have drawn the attention of investigators sooner to the role of neutrophils in the pathogenesis of GPA (WG)? A granuloma (or granulomatous inflammation) is a lesion characterized histologically by a compact accumulation of predominantly macrophages that, if large enough, grossly appears nodular.
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