Granulomatosis with polyangiitis history and symptoms: Difference between revisions

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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 signs that are present in patients with Granulomatosis with polyangiitis are non-specific in nature. The following are signs 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>
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
* [[Malaise]]
* pyrexia
* [[Pyrexia]]
* weight loss
* [[Weight loss]]
* arthralgia
* [[Arthralgia]]
* cough
* [[Cough]]
* dyspnea
* [[Dyspnea]]
* purpura
* [[Purpura]]
* abnormal urinary sediment


'''Ear, nose and throat involvement:'''
'''Ear, nose and throat involvement:'''
* nasal crusting
* [[Sinusitis]]
* sinusitis
* Nasal crusting
* otitis media
* [[Otitis media]]
* otorrhea
* [[Otorrhea]]
* epistaxis
* [[Epistaxis]]
* ulcers of the oral cavity or nasal
* Ulcers of the oral cavity or nasal
* conductive and or sensorineural hearing loss
* [[Conductive hearing loss|Conductive]] and or [[sensorineural hearing loss]]
* saddle nose deformity
* [[Saddle nose]] deformity
* masses present in the upper airway
* Masses present in the upper airway
* cranial nerve entrapment
* Cranial nerve entrapment


'''Pulmonary involvement:'''
'''Pulmonary involvement:'''
* hoarseness
* [[Hoarseness]]
* cough
* [[Cough]]
* dyspnea
* [[Dyspnea]]
* stridor
* [[Stridor]]
* hemoptysis
* [[Hemoptysis]]
* pulmonary fibrosis
* [[Pulmonary fibrosis]]
* pulmonary arterial hypertension
* [[Pulmonary arterial hypertension]]
* parenchymal lung nodules
* Parenchymal lung nodules


'''Renal involvement:'''
'''Renal involvement:'''
* glomerulonephritis
* [[Glomerulonephritis]]
* hematuria
* [[Hematuria]]
* rise in serum creatinine
* Rise in [[serum creatinine]]
* edema
* [[Edema]]
* hypertension
* [[Hypertension]]
* red cell cast


'''Cutaneous involvement:'''
'''Cutaneous involvement:'''
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Arthritis]]
[[Category:Arthritis]]

Revision as of 17:30, 2 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]

Overview

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. There are many similarities that are present between ANCA associated vacuities and Granulomatosis with polyangiitis. A history and clinical symptoms can help assess the disease.

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:

Pulmonary involvement:

Renal involvement:

Cutaneous involvement:

  • leukocytoclastic angiitis
  • livedo reticularis

Ophthalmic involvement:

  • conjunctivitis
  • ulceration of the cornea
  • episcleritis

Nervous system involvement:

  • mononeuritis multiplex
  • sensory neuropathy
  • sensorineural hearing loss
  • pachymeningitis


A diagnosis of Granulomatosis with polyangiitis can be made when three out of the six criteria are established. They are:[5]

  1. a histopathology that shows granuloma
  2. the upper respiratory tract is involved
  3. there is a stenosis that is present in larynx, trachea, and the bronchioles
  4. the pulmonary system is involved
  5. the presence of anti-neutrophil cytoplasmic antibodies
  6. the presence of glomerulonephritis

References

  1. WALTON EW (1958). "Giant-cell granuloma of the respiratory tract (Wegener's granulomatosis)". Br Med J. 2 (5091): 265–70. PMC 2026251. PMID 13560836.
  2. 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.
  3. 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.
  4. 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.
  5. 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.

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