Clinical Factors Associated with the Diagnosis of Granulomatosis with Polyangiitis

Objective To determine the predictive value of nasal endoscopic findings and symptoms in the diagnosis of granulomatosis with polyangiitis (GPA). Study Design A cross-sectional study. Setting A tertiary university hospital. Subjects and Methods A total of 116 adults were enrolled in the study: 19 pa...

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Published in:Otolaryngology-head and neck surgery 2017-03, Vol.156 (3), p.484-488
Main Authors: Eren, Erdem, Kalkan, Toygar, Arslanoğlu, Seçil, Özmen, Mustafa, Önal, Kazım, Tarhan, Emine Figen, Akar, Servet
Format: Article
Language:English
Subjects:
Cross-Sectional Studies
diagnosis
endoscopic
Endoscopy - methods
Female
Granulomatosis with Polyangiitis - diagnosis
hemorrhagic
Humans
Male
Middle Aged
nasal
Nose
Predictive Value of Tests
Wegener’s
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Summary:Objective To determine the predictive value of nasal endoscopic findings and symptoms in the diagnosis of granulomatosis with polyangiitis (GPA). Study Design A cross-sectional study. Setting A tertiary university hospital. Subjects and Methods A total of 116 adults were enrolled in the study: 19 patients with GPA, 29 patients with other rheumatic diseases, and 68 healthy volunteers. All patients were examined with a flexible endoscope, and nasal endoscopic images were recorded and evaluated blindly. The medical history of each patient was taken by a physician blinded to the patient’s diagnosis. Results Univariate analysis indicated a statistically significant difference in rhinorrhea (P = .002), postnasal drip (P = .015), epistaxis (P < .001), and saddle nose (P = .017). However, binary logistic regression analysis demonstrated that only history of epistaxis (P = .012; odds ratio, 5.6) was statistically significant in predicting GPA. Univariate analysis showed a statistically significant difference in nasal secretion (P = .028), nasal septal perforation (P < .017), nasal crusting (P < .001), nasal adhesion (P < .001), nasal granuloma (P = .017), and hemorrhagic fragile nasal mucosa (P < .001). A binary logistic regression analysis demonstrated that only hemorrhagic fragile nasal mucosa (P < .001; odds ratio, 52.9) was a statistically significant predictor of GPA. Conclusions Given the results of this study, we believe that hemorrhagic fragile nasal mucosa and history of recurrent epistaxis may put patients at risk for GPA and should be investigated accordingly.
ISSN:0194-5998
1097-6817
DOI:10.1177/0194599816685696