Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Thessaly, General University Hospital of Larissa, Larissa, Greece
Volume 35, Issue 1, March 2024
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895279936
Mediterr J Rheumatol 2022;33(1):91
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Saddle Nose with Recurrent Sinusitis and Arthralgias: a Not-to-lose Diagnosis
Abstract
This paper has no abstract.Cite this article as: Syrmou V, Simopoulou T, Bogdanos DP, Alexiou I. Saddle Nose with Recurrent Sinusitis and Arthralgias: a Not-to-lose Diagnosis. Mediterr J Rheumatol 2022;33(1):91
Article Submitted: 10 Mar 2022; Article Accepted: 20 Mar 2022; Available Online: 31 Mar 2022
https://doi.org/10.31138/mjr.33.1.91
This work is licensed under a Creative Commons Attribution 4.0 International License.
©Syrmou V, Simopoulou T, Bogdanos DP, Alexiou I.
Full Text
CLINICAL IMAGE
Nasal and lung features in a patient with Granulomatosis with Polyangiitis (GPA, formerly called Wegener’s). A 39-year-old man presented with a 6-month history of recurrent sinusitis, nose deformity (Figure 1A), low grade fever and arthralgias. ENT examination revealed nasal septum perforation (Figure 1B), and sensorineural hearing loss. He complained about dry cough and CT thorax (Figure 2) revealed multiple granulomas bilaterally. Nasal mucosa biopsy revealed signs of acute and subacute inflammatory changes with infiltration of neutrophils and histiocytes. From urine microscopy there was microscopic haematuria with glomerular red blood cells. Patient had high c-ANCA (1/160) and PR3(>100 RU/ml, NV
Figure 1. (A) saddle nose on profile; (B) nasal septum perforation with hyperplasia of the nasal mucosa.
Figure 2. CT thorax with pulmonary granulomas.
CONFLICT OF INTEREST
The authors declare no conflict of interest.
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