Otolaryngologic Manifestations of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis

Abstract

Antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis is characterized by systemic necrotizing vasculitis, and patients fall into 2 groups: those with proteinase 3–ANCA and those with myeloperoxidase-ANCA. As infections are a trigger of ANCA-associated vasculitis, this disease tends to localize in areas around the upper airway. In this study, the authors compared ear and nasal symptoms between patients with proteinase 3–ANCA and those with myeloperoxidase-ANCA. We undertook a retrospective case series study of 34 patients diagnosed with ANCA-associated vasculitis. The otologic symptoms were divided into 3 types: chronic otitis media, secretory otitis media, and sensorineural hearing loss. Chronic otitis media was more common in patients with proteinase 3–ANCA ( P = .001), whereas secretory otitis media was more frequently found in patients with myeloperoxidase-ANCA ( P = .007). Crust formation ( P = .001), saddle nose ( P = .024), and sinusitis ( P = .001) were more common in patients with proteinase 3–ANCA than in those with myeloperoxidase-ANCA. Marked differences were observed in the disease spectrum between the 2 ANCA groups.