Polyps, grommets and eosinophilic granulomatosis with polyangiitis

Area of Science:

• Otolaryngology
• Rheumatology
• Immunology

Background:

• Nasal polyposis and otitis media with effusion (OME) are common conditions.
• Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis.
• The association between these conditions requires further investigation.

Purpose of the Study:

• To investigate the potential link between nasal polyposis, refractory otitis media with effusion, and eosinophilic granulomatosis with polyangiitis (EGPA).
• To identify patients with co-existing nasal polyps and OME who may have undiagnosed EGPA.

Main Methods:

• Retrospective observational study of patients with refractory OME requiring grommet insertion and nasal polyps.
• Evaluation of patients against the diagnostic criteria for eosinophilic granulomatosis with polyangiitis (EGPA).
• Analysis of clinical, serological, and pathological findings.

Main Results:

• Sixteen patients (10 male, 6 female) were identified.
• Nine out of sixteen patients met the diagnostic criteria for EGPA.
• Common findings included paranasal sinus abnormalities, OME, asthma, and eosinophilia (serological and extravascular).

Conclusions:

• The co-occurrence of nasal polyps and resistant otitis media with effusion should prompt consideration of EGPA.
• Early recognition of EGPA in patients with these sinonasal and otological manifestations is crucial for timely management.
• Further research is warranted to elucidate the underlying pathophysiology and optimize diagnostic pathways.