Department of Medicine, University of Cambridge, Cambridge, UK.
West Suffolk Hospital, Bury St. Edmunds, Suffolk, UK.
Clin Otolaryngol. 2020 May;45(3):316-326. doi: 10.1111/coa.13524. Epub 2020 Mar 20.
ENT involvement is common in ANCA-associated vasculitis (AAV), particularly in GPA and EGPA. Early recognition and treatment is important for good outcomes, yet evidence suggests that UK ENT surgeons may not consistently recognise the early features of AAV, despite a similar incidence to vestibular schwannoma. AAV is a rapidly advancing field, with significant developments in the understanding of its pathogenesis, classification and treatment over the past decade. Relevant vasculitis mimics are also discussed with a particular focus on the increasing prevalence of vasculitis mimics driven by an increase in recreational cocaine use, as well as the emergence and reclassification of several other vasculitis mimics in the head and neck. This article reviews key recent updates in the vasculitis literature, with a particular focus on those relevant to recognition and diagnosis of AAV for the ENT surgeon. Strengths and limitations of relevant diagnostic testing are discussed, and a method of evaluation of patients with features of AAV presenting to ENT services is outlined.
ENT 受累在 ANCA 相关性血管炎（AAV）中很常见，尤其是在 GPA 和 EGPA 中。早期识别和治疗对于获得良好的结果很重要，但有证据表明，尽管英国 ENT 外科医生的发病率与前庭神经鞘瘤相似，但他们可能并不总是能识别出 AAV 的早期特征。AAV 是一个快速发展的领域，在过去十年中，人们对其发病机制、分类和治疗有了更深入的了解。还讨论了相关的血管炎模拟物，特别关注由于娱乐性可卡因使用增加导致血管炎模拟物的患病率增加，以及在头颈部出现和重新分类的几种其他血管炎模拟物。本文回顾了血管炎文献中的最新重要更新，特别关注那些与 ENT 外科医生识别和诊断 AAV 相关的更新。讨论了相关诊断测试的优缺点，并概述了评估出现 AAV 特征的 ENT 服务患者的方法。
