Beltrán Rodríguez Cabo Olga E, Tona Acedo Gabriel
Departamento de Otorrinolaringología, Servicio de Aparato Fonoarticular y Deglución, Instituto Nacional de Rehabilitación, México DF, México.
Reumatol Clin. 2011 Dec;7 Suppl 3:S7-11. doi: 10.1016/j.reuma.2011.10.002. Epub 2011 Nov 23.
First manifestations of vasculitis can appear on the head and neck, still few physicians are aware of these diseases, as they are unspecific and because other conditions like infections and allergies are more frequent. Among them, signs and symptoms like epistaxis, nasal obstruction, discharge, burning pain of sinonasal region, headache, sinus polyps and crusts, the latter found in people who live in highly polluted cities with low humidity, in patients with respiratory scleroma, atrophy, those receiving local radiotherapy, and due to other conditions. Under the crusts, many infectious agents, like Staphylococcus aureus may grow and, in addition, other signs related to active vasculitis may be found. The ENT specialist is one of the first physicians visited by patients with these signs and symptoms. Their recognition is important to readily diagnose these diseases. We have selected three vasculitidies for discussion in this paper: granulomatosis with polyangiitis (Wegener), Churg-Strauss syndrome and relapsing polychondritis, since these three diseases present initial ENT problems with high frequency.
血管炎的首发症状可能出现在头颈部，但很少有医生了解这些疾病，因为它们缺乏特异性，而且感染和过敏等其他病症更为常见。其中，鼻出血、鼻塞、流涕、鼻窦区灼痛、头痛、鼻窦息肉和结痂等体征和症状，后者见于生活在高污染、低湿度城市的人群、呼吸道硬结症患者、萎缩患者、接受局部放疗的患者以及其他情况的患者。在结痂之下，许多病原体如金黄色葡萄球菌可能生长，此外，还可能发现与活动性血管炎相关的其他体征。耳鼻喉科专家是出现这些体征和症状的患者首先就诊的医生之一。对这些体征和症状的识别对于及时诊断这些疾病很重要。本文选择了三种血管炎进行讨论：肉芽肿性多血管炎（韦格纳氏）、变应性肉芽肿性血管炎和复发性多软骨炎，因为这三种疾病高频出现首发耳鼻喉科问题。
