Upper respiratory tract involvement in patients with ANCA-associated vasculitis

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ANCA-associated vasculitides are a group of systemic inflammatory diseases characterized by the necrotizing inflammatory lesions of mainly small vessels and the frequent detection of antineutrophilic cytoplasmic antibodies (ANCA) in serum. The upper respiratory tract (URT) disease is a common manifestation of ANCA-associated vasculitis. Its occurrence and signs and symptoms depend on the clinical form of the disease. The URT involvement is usually associated with other manifestations of systemic vasculitis, such as kidney, lung, and skin disease. However, the inflammation can be limited exclusively by the URT area, as observed in 25% of patients with granulomatosis with polyangiitis. The URT involvement is characterized by variable clinical manifestations, including ulcerative necrotic lesions of the mucous membranes, polyps in the nasal cavity, destructive changes in bone and cartilage structures, stenosis of the trachea, and may be the first manifestation of ANCA-associated vasculitis. Therefore, a greater awareness of ENT specialists is essential for a timely diagnosis. A review describes the URT disease in patients with granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis.

Key words

ANCA-associated vasculitis, upper respiratory tract, granulomatosis with polyangiitis, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis.