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Localized Granulomatous with Polyangiitis (GPA): Varied Clinical Presentations and Update on Treatment

  • Autoimmunity (T Tarrant, Section Editor)
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Abstract

Purpose of Review

Granulomatosis with polyangiitis is a primary systemic vasculitis commonly described with the typical triad of upper airway, lung, and kidney involvement. Upper and lower airway involvement is characteristic in patients with granulomatosis with polyangiitis and can sometimes represent the initial or in some instances the sole manifestation. The objective of this review is to summarize the various clinical manifestations of localized disease in GPA and their treatment.

Recent Findings

Sinonasal disease is seen in up to 90% of patients. Otologic and ocular involvement is also commonly seen. Laryngeal and tracheal disease although less common is associated with significant morbidity and can be therapeutically challenging. Clinicians need to be aware of these localized GPA manifestations as they may be presenting disease features in the absence of other systemic findings. Treatment of localized GPA involves both immunosuppressive and surgical interventions for specific manifestations. Collaboration between specialists including rheumatologists, otolaryngologists, and ophthalmologists is often crucial to ensure optimal outcomes for patients.

Summary

This is a narrative review that provides a comprehensive overview of localized granulomatosis with polyangiitis and current treatment options.

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  1. Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, New York, NY, USA

    Sebastian E. Sattui

  2. Division of Rheumatology, Department of Medicine, Weill Cornell Medicine, Scleroderma, Vasculitis and Myositis Center, Hospital for Special Surgery, 525 East 71st Street, 7th Floor, New York, NY, 10021, USA

    Lindsay Lally

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Sattui, S.E., Lally, L. Localized Granulomatous with Polyangiitis (GPA): Varied Clinical Presentations and Update on Treatment. Curr Allergy Asthma Rep 20, 56 (2020). https://doi.org/10.1007/s11882-020-00953-1

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