A rare case of limited granulomatosis with polyangiitis presenting as bilateral parotitis
Background: Granulomatosis with polyangiitis (GPA) is a rare autoimmune vasculitis affecting small and medium-sized vessels, commonly involving the respiratory tract and kidneys. Salivary gland involvement, particularly bilateral parotitis, is an uncommon presentation of GPA. Case Report: We report...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SMC MEDIA SRL
2024-12-01
|
| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/4992 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841556072106557440 |
|---|---|
| author | Vandana Bandari Sandra Apenteng Aaradhana Kaul |
| author_facet | Vandana Bandari Sandra Apenteng Aaradhana Kaul |
| author_sort | Vandana Bandari |
| collection | DOAJ |
| description | Background: Granulomatosis with polyangiitis (GPA) is a rare autoimmune vasculitis affecting small and medium-sized vessels, commonly involving the respiratory tract and kidneys. Salivary gland involvement, particularly bilateral parotitis, is an uncommon presentation of GPA.
Case Report: We report the case of a 38-year-old Asian male who presented with left ear pain and parotid swelling after a water park visit. Initially treated with antibiotics for suspected otitis externa, his symptoms worsened, leading to bilateral parotitis, facial palsy, and otomastoiditis. Imaging revealed parotid abscesses and lab results showed elevated antineutrophil cytoplasmic antibodies (ANCA), specifically cytoplasmic ANCA directed against proteinase 3, confirming the diagnosis of GPA. Cultures and autoimmune workups for other causes, such as Sjogren’s syndrome and immunoglobulin G4-related disease, were negative. Treatment with high-dose corticosteroids and methotrexate resulted in significant clinical improvement.
Conclusion: This case highlights the importance of considering GPA in atypical presentations such as parotitis, even in the absence of renal involvement. Early diagnosis and appropriate immunosuppressive therapy are critical to prevent further complications in multisystem involvement. |
| format | Article |
| id | doaj-art-172a50e463b64e60b413e920139f1a51 |
| institution | Kabale University |
| issn | 2284-2594 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj-art-172a50e463b64e60b413e920139f1a512025-01-07T13:40:28ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942024-12-0110.12890/2024_0049924527A rare case of limited granulomatosis with polyangiitis presenting as bilateral parotitisVandana Bandari0Sandra Apenteng1Aaradhana Kaul2Department of Internal Medicine, Bayhealth Medical Center, Dover, USADepartment of Rheumatology, University of Connecticut, Farmington, USADepartment of Rheumatology, University of Connecticut, Farmington, USABackground: Granulomatosis with polyangiitis (GPA) is a rare autoimmune vasculitis affecting small and medium-sized vessels, commonly involving the respiratory tract and kidneys. Salivary gland involvement, particularly bilateral parotitis, is an uncommon presentation of GPA. Case Report: We report the case of a 38-year-old Asian male who presented with left ear pain and parotid swelling after a water park visit. Initially treated with antibiotics for suspected otitis externa, his symptoms worsened, leading to bilateral parotitis, facial palsy, and otomastoiditis. Imaging revealed parotid abscesses and lab results showed elevated antineutrophil cytoplasmic antibodies (ANCA), specifically cytoplasmic ANCA directed against proteinase 3, confirming the diagnosis of GPA. Cultures and autoimmune workups for other causes, such as Sjogren’s syndrome and immunoglobulin G4-related disease, were negative. Treatment with high-dose corticosteroids and methotrexate resulted in significant clinical improvement. Conclusion: This case highlights the importance of considering GPA in atypical presentations such as parotitis, even in the absence of renal involvement. Early diagnosis and appropriate immunosuppressive therapy are critical to prevent further complications in multisystem involvement.https://www.ejcrim.com/index.php/EJCRIM/article/view/4992limited granulomatosis with polyangiitisparotitisbilateral parotitis |
| spellingShingle | Vandana Bandari Sandra Apenteng Aaradhana Kaul A rare case of limited granulomatosis with polyangiitis presenting as bilateral parotitis European Journal of Case Reports in Internal Medicine limited granulomatosis with polyangiitis parotitis bilateral parotitis |
| title | A rare case of limited granulomatosis with polyangiitis presenting as bilateral parotitis |
| title_full | A rare case of limited granulomatosis with polyangiitis presenting as bilateral parotitis |
| title_fullStr | A rare case of limited granulomatosis with polyangiitis presenting as bilateral parotitis |
| title_full_unstemmed | A rare case of limited granulomatosis with polyangiitis presenting as bilateral parotitis |
| title_short | A rare case of limited granulomatosis with polyangiitis presenting as bilateral parotitis |
| title_sort | rare case of limited granulomatosis with polyangiitis presenting as bilateral parotitis |
| topic | limited granulomatosis with polyangiitis parotitis bilateral parotitis |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/4992 |
| work_keys_str_mv | AT vandanabandari ararecaseoflimitedgranulomatosiswithpolyangiitispresentingasbilateralparotitis AT sandraapenteng ararecaseoflimitedgranulomatosiswithpolyangiitispresentingasbilateralparotitis AT aaradhanakaul ararecaseoflimitedgranulomatosiswithpolyangiitispresentingasbilateralparotitis AT vandanabandari rarecaseoflimitedgranulomatosiswithpolyangiitispresentingasbilateralparotitis AT sandraapenteng rarecaseoflimitedgranulomatosiswithpolyangiitispresentingasbilateralparotitis AT aaradhanakaul rarecaseoflimitedgranulomatosiswithpolyangiitispresentingasbilateralparotitis |