Facial Palsy with Tongue Ulcer: A Rare Initial Presentation of Granulomatosis with Polyangiitis

ABSTRACT@#Granulomatosis with polyangiitis (GPA) is a rare multisystem disease. Although GPA is rare, it commonly presents in a localised stage where its manifestation involves the upper or lower respiratory tract before progressing to a generalised stage. Therefore, most patients with GPA will visit an oral surgeon or an otolaryngologist to seek treatment. However, the diagnosis of GPA is often delayed as GPA is not frequently considered as a differential diagnosis in common oral and facial diseases. The lack of gold standard investigation for the diagnosis of GPA makes management of this case, a diagnostic conundrum. We herein report a patient who was diagnosed with bilateral acute otitis media and left mastoiditis complicated with facial nerve palsy, and later developed tongue ulceration one month after his initial presentation. The ear, facial and oral symptoms represent a diagnostic red herring to a full-blown generalised stage of GPA.

Advance in the pulmonary vasculitis in children / 中华实用儿科临床杂志

Vasculitis is divided into large,medium-sized,small vasculitis based on the size of the affect vessel.Pulmonary vasculitis may affect any vessel of the lung.It was pulmonary capillaritis if capillary vessels were involved.The common pulmonary vasculitis were granulomatosis polyangiitis,microscopic polyangiitis,allergic granulomatosis angitis,the less common pulmonary vasculitis were Schonlein-Henoch purpura,Takayasu'arteritis,Giant-cell arteritis,cryglobulinemia,polyarteritis nodosa,and Bechet'disease.The clinical features of the pulmonary vasculitis were alveolar hemorrhage,hemoptysis,anemia and pulmonary infiltration,other clinical manifestation were cough,fever,weight loss.The diagnosis of the pulmonary vasculitis was based on the clinical symptoms,signs and positive anti-neutrophil cytoplasmic antibodies or lung biopsy.Large vasculitis was diagnosised by the magnetic resonance imaging and colour Doppler ultrasonography.The glucocorticoid and immunosuppressant was used in the treatment of the vasculitis.