[Musculoskeletal symptoms in a group of granulomatosis with polyangiitis patients].

ABSTRACT

OBJECTIVE: Introduction: Musculoskeletal symptoms are not characteristic for granulomatosis with polyangiitis (GPA) patients. However, they could be present in two-thirds of patients at the onset of the disease and may provoke diagnostic difficulties. The aim: To assess retrospectively musculoskeletal manifestations in a group of GPA patients. PATIENTS AND METHODS: Material and methods: The analyzed group consisted of 44 patients with GPA (27M, 17F) aged 46.7 years (16-75) and treated at the Department of Rheumatology and Connective Tissue Diseases in Lublin between 2010-2016. All patients were c-ANCA positive, and p-ANCA were present only in one patient (2.3%). The delay in GPA diagnosis averaged 15.9 months (0-166). RESULTS: Results: Joint manifestations were present in 43.2 % of patients (non-destructive arthritis in 22.7%, arthralgia in 20.5%), in 73.7% of cases anticipating GPA diagnosis by on average of 20.1 months (4-98). In 57.5% of patients joint manifestations were present from the beginning of the disease, most commonly as polyarthritis (68.4%). Myalgia was reported by 11.4% of patients. Among patients with arthritis 5 were RF-positive, none ACPA-positive, and 1 had ANA present. CONCLUSION: Conclusions: Musculoskeletal manifestations appear in a high proportion of GPA patients, in most cases preceding the diagnosis. Such a situation may cause diagnostic difficulties and the diagnosis delay.