Granulomatosis with polyangiitis history and symptoms: Difference between revisions
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{{Wegener's granulomatosis}} | {{Wegener's granulomatosis}} | ||
{{CMG}}{{APM}}{{AE}}{{KW}}{{CZ}} | {{CMG}}{{APM}}{{AE}}{{KW}}{{CZ}}{{ADS}} | ||
==Overview== | ==Overview== | ||
The symptomatology depends on the system involved. The disease involve ear nose and throat and cause symptoms of [[Sinusitis]], nasal crusting[[Otitis media|, otitis media]], [[Otorrhea]][[Epistaxis|, epistaxis]]. Patients with history of lung involvement presents with [[Hoarseness]], [[Cough]], [[Dyspnea]], [[Stridor]], [[Hemoptysis]]. Renal involvement presents with cloudy urine with [[hematuria]], [[edema]]. | |||
==History and Symptoms== | ==History and Symptoms== | ||
Obtaining a complete history is an important aspect in making a clinical diagnosis of Granulomatosis with polyangiitis. As it can help differentiate between the ANCA associated vasculitis and other possible causes that may mimic the disease. | Obtaining a complete history is an important aspect in making a clinical diagnosis of Granulomatosis with polyangiitis. As it can help differentiate between the ANCA associated vasculitis and other possible causes that may mimic the disease. | ||
The initial | The initial symptomsthat are present in patients with Granulomatosis with polyangiitis are non-specific in nature. The following are history and symptoms of Granulomatosis with polyangiitis:<ref name="pmid13560836">{{cite journal| author=WALTON EW| title=Giant-cell granuloma of the respiratory tract (Wegener's granulomatosis). | journal=Br Med J | year= 1958 | volume= 2 | issue= 5091 | pages= 265-70 | pmid=13560836 | doi= | pmc=2026251 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13560836 }}</ref><ref name="pmid2202308">{{cite journal| author=Leavitt RY, Fauci AS, Bloch DA, Michel BA, Hunder GG, Arend WP et al.| title=The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis. | journal=Arthritis Rheum | year= 1990 | volume= 33 | issue= 8 | pages= 1101-7 | pmid=2202308 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2202308 }} </ref><ref name="pmid6336643">{{cite journal| author=Fauci AS, Haynes BF, Katz P, Wolff SM| title=Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. | journal=Ann Intern Med | year= 1983 | volume= 98 | issue= 1 | pages= 76-85 | pmid=6336643 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6336643 }} </ref><ref name="pmid27733943">{{cite journal| author=Pagnoux C| title=Updates in ANCA-associated vasculitis. | journal=Eur J Rheumatol | year= 2016 | volume= 3 | issue= 3 | pages= 122-133 | pmid=27733943 | doi=10.5152/eurjrheum.2015.0043 | pmc=5058451 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27733943 }} </ref> | ||
<ref name="pmid6336643">{{cite journal| author=Fauci AS, Haynes BF, Katz P, Wolff SM| title=Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. | journal=Ann Intern Med | year= 1983 | volume= 98 | issue= 1 | pages= 76-85 | pmid=6336643 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6336643 }} </ref> | |||
<ref name="pmid27733943">{{cite journal| author=Pagnoux C| title=Updates in ANCA-associated vasculitis. | journal=Eur J Rheumatol | year= 2016 | volume= 3 | issue= 3 | pages= 122-133 | pmid=27733943 | doi=10.5152/eurjrheum.2015.0043 | pmc=5058451 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27733943 }} </ref> | |||
'''Constitutional Symptoms''' | '''Constitutional Symptoms''' | ||
* | * [[Malaise]] | ||
* | * [[Pyrexia]] | ||
* | * [[Weight loss]] | ||
* | * [[Arthralgia]] | ||
* | * [[Cough]] | ||
* | * [[Dyspnea]] | ||
* | * [[Purpura]] | ||
'''Ear, nose and throat involvement:''' | '''Ear, nose and throat involvement:''' | ||
* | * [[Sinusitis]] | ||
* | * Nasal crusting | ||
* | * [[Otitis media]] | ||
* | * [[Otorrhea]] | ||
* | * [[Epistaxis]] | ||
* | * Ulcers of the oral cavity or nasal | ||
* | * [[Conductive hearing loss|Conductive]] and or [[sensorineural hearing loss]] | ||
* | * [[Saddle nose]] deformity | ||
* | * Masses present in the upper airway | ||
* | * Cranial nerve entrapment | ||
'''Pulmonary involvement:''' | '''Pulmonary involvement:''' | ||
* | * [[Hoarseness]] | ||
* | * [[Cough]] | ||
* | * [[Dyspnea]] | ||
* | * [[Stridor]] | ||
* | * [[Hemoptysis]] | ||
* | * [[Pulmonary fibrosis]] | ||
* | * [[Pulmonary arterial hypertension]] | ||
* | * Parenchymal lung nodules | ||
'''Renal involvement:''' | '''Renal involvement:''' | ||
* | * [[Glomerulonephritis]] | ||
* | * [[Hematuria]] | ||
* | * Rise in [[serum creatinine]] | ||
* | * [[Edema]] | ||
* | * [[Hypertension]] | ||
'''Cutaneous involvement:''' | '''Cutaneous involvement:''' | ||
* | * Leukocytoclastic angiitis | ||
* | * [[Livedo reticularis]] | ||
'''Ophthalmic involvement:''' | '''Ophthalmic involvement:''' | ||
* | * [[Conjunctivitis]] | ||
* | * Ulceration of the [[cornea]] | ||
* | * [[Episcleritis]] | ||
'''Nervous system involvement:''' | '''Nervous system involvement:''' | ||
* | * [[Mononeuritis multiplex]] | ||
* | * [[Sensory neuropathy]] | ||
* | * [[Sensorineural hearing loss]] | ||
* | * [[Pachymeningitis interna|Pachymeningitis]] | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Arthritis]] | [[Category:Arthritis]] | ||
Latest revision as of 17:23, 11 April 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2]Associate Editor(s)-in-Chief: Krzysztof Wierzbicki M.D. [3]Cafer Zorkun, M.D., Ph.D. [4]Amandeep Singh M.D.[5]
Overview
The symptomatology depends on the system involved. The disease involve ear nose and throat and cause symptoms of Sinusitis, nasal crusting, otitis media, Otorrhea, epistaxis. Patients with history of lung involvement presents with Hoarseness, Cough, Dyspnea, Stridor, Hemoptysis. Renal involvement presents with cloudy urine with hematuria, edema.
History and Symptoms
Obtaining a complete history is an important aspect in making a clinical diagnosis of Granulomatosis with polyangiitis. As it can help differentiate between the ANCA associated vasculitis and other possible causes that may mimic the disease.
The initial symptomsthat are present in patients with Granulomatosis with polyangiitis are non-specific in nature. The following are history and symptoms of Granulomatosis with polyangiitis:[1][2][3][4]
Constitutional Symptoms
Ear, nose and throat involvement:
- Sinusitis
- Nasal crusting
- Otitis media
- Otorrhea
- Epistaxis
- Ulcers of the oral cavity or nasal
- Conductive and or sensorineural hearing loss
- Saddle nose deformity
- Masses present in the upper airway
- Cranial nerve entrapment
Pulmonary involvement:
- Hoarseness
- Cough
- Dyspnea
- Stridor
- Hemoptysis
- Pulmonary fibrosis
- Pulmonary arterial hypertension
- Parenchymal lung nodules
Renal involvement:
Cutaneous involvement:
- Leukocytoclastic angiitis
- Livedo reticularis
Ophthalmic involvement:
- Conjunctivitis
- Ulceration of the cornea
- Episcleritis
Nervous system involvement:
A diagnosis of Granulomatosis with polyangiitis can be made when three out of the six criteria are established. They are:[5]
- a histopathology that shows granuloma
- the upper respiratory tract is involved
- there is a stenosis that is present in larynx, trachea, and the bronchioles
- the pulmonary system is involved
- the presence of anti-neutrophil cytoplasmic antibodies
- the presence of glomerulonephritis
References
- ↑ WALTON EW (1958). "Giant-cell granuloma of the respiratory tract (Wegener's granulomatosis)". Br Med J. 2 (5091): 265–70. PMC 2026251. PMID 13560836.
- ↑ Leavitt RY, Fauci AS, Bloch DA, Michel BA, Hunder GG, Arend WP; et al. (1990). "The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis". Arthritis Rheum. 33 (8): 1101–7. PMID 2202308.
- ↑ Fauci AS, Haynes BF, Katz P, Wolff SM (1983). "Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years". Ann Intern Med. 98 (1): 76–85. PMID 6336643.
- ↑ Pagnoux C (2016). "Updates in ANCA-associated vasculitis". Eur J Rheumatol. 3 (3): 122–133. doi:10.5152/eurjrheum.2015.0043. PMC 5058451. PMID 27733943.
- ↑ Noone D, Hebert D, Licht C (2016). "Pathogenesis and treatment of ANCA-associated vasculitis-a role for complement". Pediatr Nephrol. ( ): . doi:10.1007/s00467-016-3475-5. PMID 27596099.