Manifestation of granulomatosis with polyangiitis in head and neck

Clin Exp Rheumatol. 2018 Mar-Apr;36 Suppl 111(2):78-84. Epub 2018 May 18.

Abstract

Objectives: Granulomatosis with polyangiitis is a rare autoimmune disease of the group of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides. Involvement of the ear, nose and throat (ENT)-region is only described in a few case series and case reports. The objective of this study is to systematically characterise the ENT-involvement in a large series of GPA patients.

Methods: GPA patients examined in the Department of Otorhinolayngology of the Christian-Albrechts-University of Kiel between 1990 and 2012 were included. Diagnosis was based on histological, serological and clinical parameters. GPA patients were examined in a standardised way based on the Ear Nose and Throat Activity Score (ENTAS) or its precursor. Medical history, ENT examination, diagnostic findings (ear, nose) and cranial radiology were documented cumulatively.

Results: A total of 230 GPA patients were included in this study. Over 95% of them showed ENT-involvement. 59% of the patients showed nasal obstructions, 57% a loss of smell. A hearing loss was diagnosed in 23% of the patients, 50% involvement in MR or CT scans and 15% showed laryngeal involvement.

Conclusions: The data of the largest monocentric study presented here demonstrate a frequent ENT-involvement in GPA patients. Rhinological and ontological manifestations are most common.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Audiometry, Pure-Tone
  • Dizziness / etiology
  • Dizziness / physiopathology
  • Dysphonia / etiology
  • Dysphonia / physiopathology
  • Earache / etiology
  • Earache / physiopathology
  • Epistaxis / epidemiology
  • Epistaxis / physiopathology
  • Female
  • Granulomatosis with Polyangiitis / complications
  • Granulomatosis with Polyangiitis / diagnostic imaging
  • Granulomatosis with Polyangiitis / physiopathology*
  • Hearing Loss / etiology
  • Hearing Loss / physiopathology
  • Hearing Tests
  • Humans
  • Laryngoscopy
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Olfaction Disorders / etiology
  • Olfaction Disorders / physiopathology
  • Otorhinolaryngologic Diseases / diagnostic imaging
  • Otorhinolaryngologic Diseases / etiology
  • Otorhinolaryngologic Diseases / physiopathology*
  • Otoscopy
  • Rhinitis / etiology
  • Rhinitis / physiopathology
  • Rhinomanometry
  • Tinnitus / etiology
  • Tinnitus / physiopathology
  • Young Adult