Skip Navigation Links.
Collapse <span class="m110 colortj mt20 fontw700">Volume 12 (2024)</span>Volume 12 (2024)
Collapse <span class="m110 colortj mt20 fontw700">Volume 11 (2023)</span>Volume 11 (2023)
Collapse <span class="m110 colortj mt20 fontw700">Volume 10 (2022)</span>Volume 10 (2022)
Collapse <span class="m110 colortj mt20 fontw700">Volume 9 (2021)</span>Volume 9 (2021)
Collapse <span class="m110 colortj mt20 fontw700">Volume 8 (2020)</span>Volume 8 (2020)
Collapse <span class="m110 colortj mt20 fontw700">Volume 7 (2019)</span>Volume 7 (2019)
Collapse <span class="m110 colortj mt20 fontw700">Volume 6 (2018)</span>Volume 6 (2018)
Collapse <span class="m110 colortj mt20 fontw700">Volume 5 (2017)</span>Volume 5 (2017)
Collapse <span class="m110 colortj mt20 fontw700">Volume 4 (2016)</span>Volume 4 (2016)
Collapse <span class="m110 colortj mt20 fontw700">Volume 3 (2015)</span>Volume 3 (2015)
Collapse <span class="m110 colortj mt20 fontw700">Volume 2 (2014)</span>Volume 2 (2014)
Collapse <span class="m110 colortj mt20 fontw700">Volume 1 (2013)</span>Volume 1 (2013)
American Journal of Medical Case Reports. 2018, 6(1), 12-14
DOI: 10.12691/AJMCR-6-1-4
Case Report

A unique Presentation of Granulomatosis with Polyangiitis in a Patient of African-Caribbean Descent

Stefan Rodic1, and Richard Dunbar-Yaffe2

1Schulich School of Medicine, Western University, London, Canada

2Division of General Internal Medicine, University of Toronto, Toronto, Canada

Pub. Date: February 01, 2018

Cite this paper

Stefan Rodic and Richard Dunbar-Yaffe. A unique Presentation of Granulomatosis with Polyangiitis in a Patient of African-Caribbean Descent. American Journal of Medical Case Reports. 2018; 6(1):12-14. doi: 10.12691/AJMCR-6-1-4

Abstract

Herein, we present a case of limited granulomatosis with polyangiitis (GPA) with ocular/aural involvement and sparing of the visceral organs. This atypical constellation of symptoms was initially thought to have an infectious cause prior to repeat imaging and testing of immunological markers. The patient was of African-Caribbean descent, a population where the incidence of granulomatosis with polyangiitis is exceedingly uncommon. This case highlights a unique variant of GPA and emphasizes the importance of early clinical detection and treatment to prevent associated morbidity and mortality.

Keywords

granulomatosis, polyangiitis, vasculitis, GPA, ocular, aural, ANCA

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Walton, E.W., Giant-cell Granuloma of the Respiratory Tract (Wegener's Granulomatosis). British Medical Journal, 2(5091). p. 265-270. 1958.
 
[2]  Ntatsaki, E., Watts, R.A., and Scott, D.G., Epidemiology of ANCA-associated vasculitis. Rheum Dis Clin North Am, 36(3). p. 447-61. 2010.
 
[3]  Terrier, B., Dechartres, A., Deligny, C., Godmer, P., Charles, P., Hayem, G., Dunogue, B., de Bandt, M., Cohen, P., Puechal, X., Jeunne, C.L., Arfi, S., Mouthon, L., and Guillevin, L., Granulomatosis with polyangiitis according to geographic origin and ethnicity: clinical-biological presentation and outcome in a French population. Rheumatology (Oxford), 56(3). p. 445-450. 2017.
 
[4]  Rao, J.K., Weinberger, M., Oddone, E.Z., Allen, N.B., Landsman, P., and Feussner, J.R., The role of antineutrophil cytoplasmic antibody (c-ANCA) testing in the diagnosis of Wegener granulomatosis. A literature review and meta-analysis. Ann Intern Med, 123(12). p. 925-32. 1995.
 
[5]  Yoo, J.,Kim, H.J.,Ahn, S.S.,Jung, S.M.,Song, J.J.,Park, Y.B., and Lee, S.W., The utility of the ACR/EULAR 2017 provisional classification criteria for granulomatosis with polyangiitis in Korean patients with antineutrophil cytoplasmic antibody-associated vasculitis. Clin Exp Rheumatol. 2017.
 
[6]  Drinias, V. and Florentzson, R., Facial palsy and Wegener's granulomatosis. Am J Otolaryngol, 25(3). p. 208-12. 2004.
 
[7]  Shuto, J., Suenaga, S.,Tateyama, K.,Oribe, K., and Suzuki, M., [Acute onset Wegener's granulomatosis presenting as otitis media; a case report]. Nihon Jibiinkoka Gakkai Kaiho, 110(3). p. 107-10. 2007.
 
[8]  Takagi, D., Nakamaru, Y., Maguchi, S., Furuta, Y., and Fukuda, S., Otologic manifestations of Wegener's granulomatosis. Laryngoscope, 112(9). p. 1684-90. 2002.
 
[9]  Soukiasian, S.H., Jakobiec, F.A., Niles, J.L., and Pavan-Langston, D., Trimethoprim-sulfamethoxazole for scleritis associated with limited Wegener's granulomatosis: use of histopathology and anti-neutrophil cytoplasmic antibody (ANCA) test. Cornea, 12(2). p. 174-80. 1993.
 
[10]  Willeke, P., Schluter, B., Limani, A., Becker, H., and Schotte, H., Liver involvement in ANCA-associated vasculitis. Clin Rheumatol, 35(2). p. 387-94. 2016.
 
[11]  Bhat, M.A., Prasad, K.V.V., Trivedi, D., Rajeev, B.R., and Battur, H., Pyruvic acid levels in serum and saliva: A new course for oral cancer screening? Journal of Oral and Maxillofacial Pathology: JOMFP, 20(1). p. 102-105. 2016.
 
[12]  Israel, H.L., Sulfamethoxazole-trimethoprim therapy for Wegener's granulomatosis. Arch Intern Med, 148(10). p. 2293-5. 1988.
 
[13]  Valeriano-Marcet, J. and Spiera, H., Treatment of Wegener's granulomatosis with sulfamethoxazole-trimethoprim. Arch Intern Med, 151(8). p. 1649-52. 1991.
 
[14]  Stegeman, C.A., Tervaert, J.W.,de Jong, P.E., and Kallenberg, C.G., Trimethoprim-sulfamethoxazole (co-trimoxazole) for the prevention of relapses of Wegener's granulomatosis. Dutch Co-Trimoxazole Wegener Study Group. N Engl J Med, 335(1). p. 16-20. 1996.
 
[15]  Zycinska, K., Wardyn, K.A., Zielonka, T.M., Krupa, R., and Lukas, W., Co-trimoxazole and prevention of relapses of PR3-ANCA positive vasculitis with pulmonary involvement. Eur J Med Res, 14 Suppl 4. p. 265-7. 2009.
 
[16]  Clements, M.R., Mistry, C.D., Keith, A.O., and Ramsden, R.T., Recovery from sensorineural deafness in Wegener's granulomatosis. J Laryngol Otol, 103(5). p. 515-8. 1989.