Do you know otitis media with ANCA-Associated Vasculitis (OMAAV)?

Area of Science:

• Immunology
• Otolaryngology
• Pulmonology

Background:

• Otolaryngic Myeloperoxidase Antineutrophil Cytoplasmic Antibody Vasculitis (OMAAV) is a rare condition that can be challenging to diagnose early.
• Hearing loss is often the sole initial symptom, complicating timely identification.

Observation:

• A case of OMAAV in a 70-year-old woman presenting with hearing loss and dry cough.
• Otoscopy revealed otitis media with effusion, and audiometry indicated mixed hearing loss, predominantly in the right ear.
• Diagnostic workup included positive serum myeloperoxidase antineutrophil cytoplasmic antibody, lung lesions with interstitial pneumonia on imaging, and findings suggestive of microscopic polyangiitis during bronchoscopy.

Findings:

• Treatment with prednisolone led to improvement in both respiratory and otologic symptoms.
• The patient's condition responded positively to immunosuppressive therapy.

Implications:

• OMAAV should be considered in the differential diagnosis for patients presenting with acute otologic symptoms.
• Concurrent evaluation for lung and/or renal disease is recommended in such cases to facilitate early OMAAV detection.
• This case highlights the importance of a multidisciplinary approach in diagnosing and managing rare vasculitic conditions affecting multiple organ systems.