Granulomatosis with Polyangiitis: The Relationship Between Ocular and Nasal Disease

Abstract

Purpose: To analyze the relationship between ocular manifestations and nasal pathology.

Methods: A retrospective study of 19 granulomatosis with polyangiitis (GPA) patients with ophthalmic and nasal manifestations.

Results: Ten cases exhibited changes in orbital structure accompanied by changes in paranasal sinuses, 2 cases had chronic dacryocystisis, and 1 case had nasolacrimal canal stenosis. Among the 17 cases that were finally diagnosed by biopsy, 12 cases were diagnosed by nasal mucosa biopsy. Sixteen GPA cases were diagnosed by CT or MRI. Nasal involvement alone or with orbital involvement was detected in 14 cases. All cases were misdiagnosed for 2–36 months.

Conclusions: Granulomatosis with polyangiitis with ocular and upper respiratory diseases as the first symptom is easily misdiagnosed. Patients with ocular and upper respiratory diseases should be given a laboratory ANCA test, nasal mucosa biopsy, and imaging of the orbit, nasal cavity, and paranasal sinuses to establish early diagnosis of GPA.

• Antineutrophilic cytoplasmic antibodies
• CT
• granulomatosis with polyangiitis
• MRI
• ophthalmic manifestations