Fernández-Enseñat Julia, Benavides-Villanueva Fabricio, Martínez-Camerano Andrea, Calvo-Rio Vanesa, Blanco Ricardo, Morales-Angulo Carmelo
Otorhinolaryngology Department, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain.
Rheumatology Deparment, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain.
Acta Otorrinolaringol Esp (Engl Ed). 2025 Jun 19:512263. doi: 10.1016/j.otoeng.2025.512263.
Eosinophilic granulomatosis with polyangiitis (EGPA) is an ANCA-associated vasculitis affecting multiple systems, with common ear, nose and throat (ENT) manifestations. This study aimed to evaluate the most frequent ENT manifestations in EGPA patients and the relationship between nasal polyps and other clinical findings such as ANCA tests and eosinophilia.
A retrospective observational study was conducted on EGPA patients diagnosed between 2000 and 2024 at a tertiary hospital using the 2022 ACR/EULAR criteria. Head and neck examinations, including audiometry, and their imaging and histopathological studies were reviewed. Patients were classified based on the presence or absence of nasal polyps, and the relationship between ANCA positivity and eosinophilia was assessed.
Of 173 patients with ANCA vasculitis, 22 met EGPA criteria, with a prevalence of 3.6 per 100,000 in Cantabria. Head and neck manifestations were observed in 90.5% of patients (19/21). Sinonasal involvement was the most frequent (82%), with otological manifestations in 31.8% (7/21). Nasal polyps were the most common manifestation (7/21). Head and neck biopsies were performed in 7 cases (32%), which showed no evidence of vasculitis. There was no statistically significant association between nasal polyps, ANCA positivity, and eosinophilia.
Sinonasal involvement is prevalent in EGPA, often presenting as chronic rhinitis or rhinosinusitis with or without polyps. Otological issues, such as eustachian tube dysfunction and sensorineural hearing loss, are also common. No laryngeal, oral, or salivary gland lesions were observed. There was no significant correlation between the presence of polyps and ANCA positivity or eosinophilia.
嗜酸性肉芽肿性多血管炎（EGPA）是一种与抗中性粒细胞胞浆抗体（ANCA）相关的血管炎，可累及多个系统，常伴有耳、鼻、喉（ENT）表现。本研究旨在评估EGPA患者最常见的耳鼻喉科表现，以及鼻息肉与其他临床检查结果（如ANCA检测和嗜酸性粒细胞增多）之间的关系。
对2000年至2024年期间在一家三级医院根据2022年美国风湿病学会（ACR）/欧洲抗风湿病联盟（EULAR）标准诊断为EGPA的患者进行了一项回顾性观察研究。回顾了包括听力测试在内的头颈部检查及其影像学和组织病理学研究。根据鼻息肉的有无对患者进行分类，并评估ANCA阳性与嗜酸性粒细胞增多之间的关系。
在173例ANCA血管炎患者中，22例符合EGPA标准，在坎塔布里亚的患病率为每10万人中3.6例。90.5%（19/21）的患者有头颈部表现。鼻窦受累最为常见（82%），耳部表现占31.8%（7/21）。鼻息肉是最常见的表现（7/21）。7例（32%）患者进行了头颈部活检，未发现血管炎证据。鼻息肉、ANCA阳性和嗜酸性粒细胞增多之间无统计学显著关联。
鼻窦受累在EGPA中很常见，常表现为慢性鼻炎或鼻窦炎，伴有或不伴有息肉。耳部问题，如咽鼓管功能障碍和感音神经性听力损失也很常见。未观察到喉部、口腔或唾液腺病变。息肉的存在与ANCA阳性或嗜酸性粒细胞增多之间无显著相关性。
