Granulomatosis with Polyangiitis

Rare disorder characterized by inflammation of small- and medium-sized blood vessels (vasculitis) that results in damage to various organ systems of the body, most often the respiratory tract and kidneys

Aetiology

  • Autoimmune disorder of unknown aetiology
  • Characterised by a small vessel vasculitis and necrosis, usually limited to respiratory tract and kidneys
  • Rare, usually patients >40 years

Clinical presentation

  • Features depend on system(s) involved
  • ENT features: sinusitis, nasal crushing, epistaxis, mouth ulcers, sensorineural deafness, otitis media and deafness, 'saddle nose' (due to cartilage damage from ischaemia), subglottic inflammation

Investigations

  • Characterised by high frequency of anti-neutrophil cytoplasmic antibody levels - ANCA positive
    • cANCA - GPA
    • pANCA - microscopic polyangiitis

Management

  • Most cases require treatment with IV steroids and cyclophosphamide due to their aggressive disease course