Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Otolaryngol Head Neck Surg. 2012 Jan;146(1):119-21. doi: 10.1177/0194599811424044. Epub 2011 Oct 10.
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is characterized by systemic necrotizing vasculitis, and patients fall into 2 groups: those with proteinase 3-ANCA and those with myeloperoxidase-ANCA. As infections are a trigger of ANCA-associated vasculitis, this disease tends to localize in areas around the upper airway. In this study, the authors compared ear and nasal symptoms between patients with proteinase 3-ANCA and those with myeloperoxidase-ANCA. We undertook a retrospective case series study of 34 patients diagnosed with ANCA-associated vasculitis. The otologic symptoms were divided into 3 types: chronic otitis media, secretory otitis media, and sensorineural hearing loss. Chronic otitis media was more common in patients with proteinase 3-ANCA (P = .001), whereas secretory otitis media was more frequently found in patients with myeloperoxidase-ANCA (P = .007). Crust formation (P = .001), saddle nose (P = .024), and sinusitis (P = .001) were more common in patients with proteinase 3-ANCA than in those with myeloperoxidase-ANCA. Marked differences were observed in the disease spectrum between the 2 ANCA groups.
抗中性粒细胞胞质抗体（ANCA）相关性血管炎的特征为系统性坏死性血管炎，患者可分为 2 组：蛋白酶 3-ANCA 阳性组和髓过氧化物酶-ANCA 阳性组。由于感染是 ANCA 相关性血管炎的触发因素，因此这种疾病往往定位于上呼吸道周围区域。在这项研究中，作者比较了蛋白酶 3-ANCA 阳性和髓过氧化物酶-ANCA 阳性患者的耳部和鼻部症状。我们对 34 例诊断为 ANCA 相关性血管炎的患者进行了回顾性病例系列研究。耳部症状分为 3 种类型：慢性中耳炎、分泌性中耳炎和感音神经性听力损失。蛋白酶 3-ANCA 阳性患者更常见慢性中耳炎（P =.001），而髓过氧化物酶-ANCA 阳性患者更常发生分泌性中耳炎（P =.007）。蛋白酶 3-ANCA 阳性患者的鼓膜穿孔（P =.001）、鞍鼻（P =.024）和鼻窦炎（P =.001）更为常见。这两组 ANCA 阳性患者的疾病谱存在显著差异。
