Ear, nose, throat and airways disease in granulomatosis with polyangiitis

Rheumatology key messagesENT disease is common in GPA (70 –99% cases).ENT features, such as nasal pain, worsening nasal crusting, epistaxis/bloody rhinorrhoea, stridor or sudden hearing loss, are associated with vasculitic disease activity, particularly with onset in the past 4  weeks.Rigid nasendoscopic examination is sensitive for the detection of mucosal inflammation, ulceration, granulation or friable mucosa, which indicate active GPA.Flexible nasendoscopic examination is not reliable for evaluating the subglottis and is unable to visualize the distal respiratory tract, where distal airway stenoses often coexist.Sudden hearing loss should prompt ENT assessment and audiogram within 24  h and an urgent increase in immunotherapy.Where possible, surgical procedures for ENT manifestations of vasculitis should be deferred until the disease is in stable remission.
Source: Rheumatology - Category: Rheumatology Source Type: research