Quality of life of patients with granulomatosis with polyangiitis and ENT disease: a controlled cross-sectional study

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To evaluate quality of life (QoL) of patients with granulomatosis with polyangiitis (GPA) and ENT involvement using Sino-Nasal Outcome Test-22 (SNOT-22) questionnaire.

Material and methods

In a cross-sectional study, we enrolled 60 patients with long-standing GPA and ENT involvement (median duration of 87 months) and 100 patients with ENT diseases (deviated septum or chronic rhinitis/rhinosinusitis).


Median total SNOT-22 scores were 36 (22, 55) in patients with GPA and 46 (38, 54) in control patients (p=0.003). Median score from “nasal symptoms” domain also suggested less significant sinonasal morbidity in GPA patients compared with control patients (12 [8; 18] and 23 [19; 26], respectively; p<0.001). Patients with GPA frequently selected the following items as the most important: fatigue (40.0%), reduced productivity (37.7%), nasal blockage (33.3%), thick nasal discharge (31.7%), post-nasal discharge (31.7%), and ear fullness (26.7%). The percentage of patients who were most affected by “nasal symptoms” in the GPA group was lower than in the control group (71.7% vs. 99.0%), whereas in the former group there were more patients who selected the most important items from the “otologic symptoms” (45.0% vs. 11.0%), “sleep symptoms” (71.7% vs. 31.0%), and “emotional symptoms” (13.3% vs. 0%) domains (all p<0.001).


Our findings suggest that accrual of the ENT damage in GPA patients is associated with permanent impairment in QoL and may impact various domains of the SNOT-22 questionnaire after median follow-up of more than 7 years.

Key words

Granulomatosis with polyangiitis, ENT, quality of life, SNOT-22