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DOI: 10.1055/s-0040-1711052
From grommet to coronary stenting in two months. The rapid progression of Granulomatosis with Polyangiitis (GPA) in a 17- year-old patient. A case report
Granulomatosis with polyangiitis (GPA) is a necrotising vasculitis of the small vessels, which presents in many cases with initial symptoms in the head and neck area. The rarity of the disease combined with the danger of a rapid progression to a life-threatening condition poses a challenging task for oto-rhino-laryngologists.
We present the case of a seventeen-year-old male, who initially showed symptoms of acute otitis media and mastoiditis. Although a mastoidectomy was performed, the inflammation spread to the skull base with ipsilateral paresis of the cranial nerves V, VII, VIII, IX, X and XII and pachymeningitis. Shortly afterwards pulmonary haemorrhage, renal infarction and myocardial infarction ensued due to vasculitis. The life of the patient could be saved by initializing immunosuppressive therapy.
The case demonstrates the pivotal role of an early diagnosis of GPA. The pitfalls in the process to the right diagnosis are illustrated. By the example of this case, symptoms and organ manifestations in GPA are addressed as well as necessary diagnostic steps and therapeutic options.
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Publication History
Article published online:
10 June 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
© Georg Thieme Verlag KG
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