Vasculitis that did not read the books

A 29-year-old woman presented to our rheumatology clinic with a 6-month history of cough, dysphonia, dyspnoea and weight loss. She also complained of a lump in her throat (globus pharyngeus), left otalgia and hearing loss. One month before evaluation, she started experiencing blood-tinged sputum and dyspnoea. On clinical examination, the patient had nasal discharge, crusting and congestion, laryngeal oedema, stridor, tympanic membrane retraction and external auditory canal ecchymosis. Laboratory findings showed anaemia (haemoglobin: 75.4 g/L, normal: 122.0–181.9), lymphocytosis 4.63x109/L (normal: 0.60x109–3.4x109/L), C reactive protein 13 mg/L and erythrocyte sedimentation rate 10 mm/hour. Serum creatinine level and urinalysis with urine sediment findings were normal. CT scan revealed sinonasal congestion, laryngeal oedema, pulmonary nodules and a symmetric 5 mm thickening of the aortic wall from the ascending to the descending aorta (figure 1). Bronchoscopy revealed ulcerated lesions in the trachea. Bacterial, fungal and mycobacterial cultures were negative. Reverse transcription PCR and interferon-gamma...
Source: Annals of the Rheumatic Diseases - Category: Rheumatology Authors: Tags: ARD, Images in rheumatology Source Type: research