[Musculoskeletal symptoms in a group of granulomatosis with polyangiitis patients]

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Musculoskeletal symptoms are not typically associated with granulomatosis with polyangiitis (GPA).
• However, these symptoms can manifest in up to two-thirds of GPA patients at disease onset, potentially leading to diagnostic challenges.
• Understanding these manifestations is crucial for timely diagnosis and management of GPA.

Purpose of the Study:

• To retrospectively evaluate the prevalence and characteristics of musculoskeletal manifestations in patients diagnosed with GPA.
• To analyze the temporal relationship between musculoskeletal symptoms and the diagnosis of GPA.
• To identify potential diagnostic difficulties associated with these symptoms in GPA.

Main Methods:

• Retrospective analysis of 44 patients (27 male, 17 female) diagnosed with GPA between 2010-2016.
• All patients were c-ANCA positive; one patient (2.3%) was p-ANCA positive.
• Data collected included demographics, clinical manifestations, diagnostic delay, and serological markers.

Main Results:

• Joint manifestations were observed in 43.2% of GPA patients, including non-destructive arthritis (22.7%) and arthralgia (20.5%).
• In 73.7% of cases, joint symptoms preceded the GPA diagnosis by an average of 20.1 months.
• Myalgia was reported by 11.4% of patients; arthritis was often polyarticular and present from the disease onset (57.5%).

Conclusions:

• Musculoskeletal manifestations are frequent in GPA patients and often precede diagnosis.
• The presence of joint symptoms can lead to diagnostic delays and difficulties in recognizing GPA.
• Early recognition of these symptoms is vital for improving patient outcomes in GPA.