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一例误诊为慢性鼻窦炎伴息肉的肉芽肿性多血管炎病例。

A Case of Granulomatosis With Polyangiitis Mimicking Chronic Sinusitis With Polyp.

作者信息

Oh Minji, Heo Sung Jae

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

出版信息

J Rhinol. 2025 Jul;32(2):113-116. doi: 10.18787/jr.2025.00036. Epub 2025 Jul 22.

Abstract

A diagnosis of granulomatosis with polyangiitis (GPA) can be challenging due to its diverse and nonspecific clinical manifestations, and it is often misdiagnosed as a simple inflammatory disease. Since the nasal septum is the most commonly involved site in the nose, GPA is typically suspected in cases presenting with septal perforation or inflammation. It is very rare for the septum to remain intact while GPA involves only the sinus, which may lead to misdiagnosis as simple sinusitis. A 64-year-old man visited our hospital after being diagnosed with chronic sinusitis at a private clinic. He showed no abnormalities in the septum, but pansinusitis was noted on computed tomography, and GPA was suspected based on a biopsy of a mass resembling a nasal polyp performed in the outpatient setting. The diagnosis of GPA was ultimately confirmed through further laboratory evaluation. Here, we present a case of GPA and review the recently revised diagnostic criteria for GPA.

摘要

肉芽肿性多血管炎(GPA)的诊断具有挑战性,因为其临床表现多样且不具特异性,常被误诊为单纯的炎症性疾病。由于鼻中隔是鼻部最常受累的部位,对于出现鼻中隔穿孔或炎症的病例,通常会怀疑GPA。当GPA仅累及鼻窦而鼻中隔保持完整时非常罕见,这可能导致误诊为单纯性鼻窦炎。一名64岁男性在一家私人诊所被诊断为慢性鼻窦炎后前来我院就诊。他的鼻中隔未见异常,但计算机断层扫描显示全鼻窦炎,基于门诊对一个类似鼻息肉肿物的活检怀疑为GPA。GPA的诊断最终通过进一步的实验室检查得以证实。在此,我们报告一例GPA病例并回顾最近修订的GPA诊断标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d0a/12313535/c840ee4b1bd7/jr-2025-00036f1.jpg

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