A Case Series of Granulomatosis With Polyangiitis Primarily Diagnosed by Otological Manifestations

Autor: Ronald Sahyouni, Phuonganh Le, Jack Birkenbeuel, Dillon Cheung, Omid Moshtaghi, Hamid R. Djalilian, Mehdi Abouzari, Harrison W. Lin
Rok vydání: 2019
Předmět:
Zdroj: The Annals of otology, rhinology, and laryngology, vol 128, iss 3
Sahyouni, Ronald; Moshtaghi, Omid; Abouzari, Mehdi; Le, Phuonganh; Birkenbeuel, Jack; Cheung, Dillon; et al.(2018). A Case Series of Granulomatosis With Polyangiitis Primarily Diagnosed by Otological Manifestations.. The Annals of otology, rhinology, and laryngology, 3489418815517. doi: 10.1177/0003489418815517. UC Irvine: Retrieved from: http://www.escholarship.org/uc/item/4557x20h
Popis: Objective: To describe a case series of previously undiagnosed granulomatosis with polyangiitis (GPA) patients who presented primarily with otological manifestations. Method: We report a series of patients visited at a neurotology clinic who were eventually diagnosed with GPA based on their otologic complaints and had no prior knowledge of having this condition. Results: In this series, 10 (91%) patients presented with hearing loss (HL), more than half of which were bilateral (60%). Upon audiometric examination, all but 1 patient had mixed, conductive, or sensorineural HL. All patients presented with eustachian tube dysfunction (ETD), otitis media with effusion (OME), or both. Nasal endoscopy showed intranasal pathology in 3 (27%) patients. Otologic symptoms were improved in all patients after treatment with an average of 4 in-office follow-up appointments. Conclusion: GPA should be included in the differential diagnosis of adults with unexplained mixed hearing loss, new onset serous effusion, or acute otitis media in the absence of a previous history of ETD. Laboratory tests (ie, anti-neutrophil cytoplasmic autoantibody, erythrocyte sedimentation rate, and C-reactive protein) along with a urinalysis can aid in screening these patients. In cases in which the index of suspicion is high, repeated testing could reduce the risk of false negative findings.
Databáze: OpenAIRE