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Rhinologic and sinonasal changes in PR3 ANCA pulmonary vasculitis
Katarzyna Zycinska1, K A Wardyn, E Piotrowska
1Department of Family Medicine, Internal and Metabolic Diseases, Warsaw Medical University, Warsaw, Poland. kzycinska@poczta.fm
European Journal of Medical Research
|December 15, 2010
Summary
PR3-associated ANCA vasculitis frequently impacts the nasal cavity and sinuses, causing bony destruction and inflammation. CT scans are valuable for diagnosing and monitoring Wegener
Area of Science:
- Otorhinolaryngology
- Radiology
- Immunology
Background:
- Granulomatosis with polyangiitis (Wegener's granulomatosis) often presents with upper respiratory tract symptoms, including nasal obstruction and chronic rhinosinusitis.
- PR3-ANCA vasculitis commonly affects the nasal cavity, leading to symptoms like bloody discharge, crusting, and potentially saddle nose deformity.
- Destructive changes can extend to paranasal sinuses, maxillary ostia, turbinates, and soft palate.
Purpose of the Study:
- To characterize nasal and sinonasal pathologies on CT scans in patients with PR3-ANCA positive vasculitis.
- To establish CT diagnostic criteria for Wegener's granulomatosis (WG) involving the sinonasal region.
Main Methods:
- Retrospective analysis of sinonasal CT scans from 35 patients (19 female, 16 male) with PR3-ANCA positive WG.
- Data collected between 2005 and 2009.
Main Results:
- Bony destruction of the nasal cavity (42.8%) and damage/distortion of paranasal sinuses (57.1%) were common findings.
- Sclerosing osteitis affected the nasal cavity (31.4%) and paranasal sinuses (68.5%).
- Septal perforation (31.4%) and saddle nose deformity (20%) were observed, with maxillary sinuses being the most frequently affected region.
Conclusions:
- Maxillary sinuses are the most commonly affected sites in PR3-ANCA pulmonary vasculitis.
- CT imaging serves as a valuable adjunct to clinical assessment and activity scoring in WG with pulmonary involvement.
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