Atlantoaxial subluxation and nasopharyngeal necrosis complicating suspected granulomatosis with polyangiitis
| Autor: | Terrence F. Holekamp, Lukas P. Zebala, Richard Brasington, Anand Mohapatra, Jason Diaz |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Pathology
medicine.medical_specialty medicine.medical_treatment Joint Dislocations Antibodies Antineutrophil Cytoplasmic Lesion Necrosis stomatognathic system Rheumatology Biopsy medicine Humans Cyclophosphamide Anti-neutrophil cytoplasmic antibody medicine.diagnostic_test business.industry Granulomatosis with Polyangiitis Middle Aged medicine.disease Spinal cord medicine.anatomical_structure Nasopharyngeal Diseases Spinal Fusion Treatment Outcome Atlanto-Axial Joint Atlantoaxial instability Spinal fusion Female medicine.symptom Vasculitis business Granulomatosis with polyangiitis Biomarkers Immunosuppressive Agents |
| Zdroj: | Journal of clinical rheumatology : practical reports on rheumaticmusculoskeletal diseases. 21(3) |
| ISSN: | 1536-7355 |
| Popis: | Granulomatosis polyangiitis (GPA, formerly Wegener granulomatosis) is a vasculitis that typically involves the upper respiratory tract, lungs, and kidneys. The 2 established methods to confirm a suspicion of GPA are the antineutrophil cytoplasmic antibody (ANCA) test and biopsy. However, ANCA-negative cases have been known to occur, and it can be difficult to find biopsy evidence of granulomatous disease.We report a case of suspected granulomatosis with polyangiitis limited to the nasopharynx. With a negative ANCA and no histological evidence, our diagnosis was founded on the exclusion of other diagnoses and the response to cyclophosphamide therapy. This case is unique because the patient's lesion resulted in atlantoaxial instability, which required a posterior spinal fusion at C1-C2. This is the first reported case of suspected GPA producing damage to the cervical spine and threatening the spinal cord. |
| Databáze: | OpenAIRE |
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