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- Title
Granulomatosis with polyangiitis: a rare case in an adolescent.
- Authors
de Oliveira Silva, Tayanne; Hatab de Castro, Fernanda; Gonçalves Pinheiro, Lucas; Bezerra de Sá, Dayanne Aline; Monteiro Passos, Bárbara; Bianco de Abreu, Mariana Aguiar; Ferreira Moreira, Raquel
- Abstract
Introduction: Granulomatosis with polyangiitis (GPA) is a necrotizing vasculitides of autoimmune origin affecting smallsized arteries predominantly that present variably in terms of organ manifestations and disease severity. Objectives: Report a case of Granulomatosis with polyangiitis in a paciente admitted to Otorhinolaryngology departmet of Hospital Santa Marcelina (HSM) in São Paulo, as well as discuss its diagnostic approach and treatment. Resumed report: I.S.B, 14 years old, male, history of dry cough and epistaxis that in 15 days progressed to purulent rhinorrhea, fever, headache, dyspnea, hemoptysis, anorexia and fever. He was hospitalized and medicated with Piperacillin-Tazobactam, with no improvement. Nasofibrolaringoscopy showed rhinorrhea purulent nasal discharge with no other changes. Sinus computed tomography (CT) was performed with signs of acute sinusitis, with an air level in the maxillary and frontal sinuses. Chest CT showed multiple pulmonary cavitary nodules. Lab evidenced an increase in C-reative protein and negative antineutrophil cytoplasmic antibodies. We opted for biopsy of the inferior turbinate, that showed necrotizing granulomatous inflammatory process in the nasal cavity mucosa, suggestive of granulomatosis with polyangiitis (GPA). Evaluated by the infectology that guided the pulse of Cyclophosphamide and corticosteroid therapy and maintenance of treatment with Methotrexate. There was remission of symptoms. Conclusion: Although rare, its diagnosis must be considered in cases with refractory acute sinusites so that there is a correct clinical follow-up and prevention of complications.
- Subjects
SAO Paulo (Brazil); GRANULOMATOSIS with polyangiitis; POLYARTERITIS nodosa; PULMONARY nodules; ANTINEUTROPHIL cytoplasmic antibodies; MAXILLARY sinus diseases; NASAL mucosa; NASAL cavity
- Publication
International Archives of Otorhinolaryngology, 2022, Vol 26, p26
- ISSN
1809-9777
- Publication type
Case Study