Skip to main content
A Case Series of Granulomatosis With Polyangiitis Primarily Diagnosed by Otological Manifestations.
- Author(s): Sahyouni, Ronald;
- Moshtaghi, Omid;
- Abouzari, Mehdi;
- Le, Phuonganh;
- Birkenbeuel, Jack;
- Cheung, Dillon;
- Lin, Harrison W;
- Djalilian, Hamid R
- et al.
Published Web Locationhttps://doi.org/10.1177/0003489418815517
ObjectiveTo describe a case series of previously undiagnosed granulomatosis with polyangiitis (GPA) patients who presented primarily with otological manifestations.
MethodWe report a series of patients visited at a neurotology clinic who were eventually diagnosed with GPA based on their otologic complaints and had no prior knowledge of having this condition.
ResultsIn this series, 10 (91%) patients presented with hearing loss (HL), more than half of which were bilateral (60%). Upon audiometric examination, all but 1 patient had mixed, conductive, or sensorineural HL. All patients presented with eustachian tube dysfunction (ETD), otitis media with effusion (OME), or both. Nasal endoscopy showed intranasal pathology in 3 (27%) patients. Otologic symptoms were improved in all patients after treatment with an average of 4 in-office follow-up appointments.
ConclusionGPA should be included in the differential diagnosis of adults with unexplained mixed hearing loss, new onset serous effusion, or acute otitis media in the absence of a previous history of ETD. Laboratory tests (ie, anti-neutrophil cytoplasmic autoantibody, erythrocyte sedimentation rate, and C-reactive protein) along with a urinalysis can aid in screening these patients. In cases in which the index of suspicion is high, repeated testing could reduce the risk of false negative findings.
For improved accessibility of PDF content, download the file to your device.