Abstract
INTRODUCTION: Granulomatosis with polyangiitis (GPA) is an important form of AAV (ANCA associated vasculitis) syndrome. Being a multisystem disease, it can manifest in several combinations and can mimic an infection or malignancy. CASE PRESENTATION: A 55 years old man presented with cough, expectoration, haemoptysis, chronic otorrhoea and hearing loss. Imaging study suggested malignant mass lesion in right upper lobe with metastasis. HRCT of Temporal bones showed chronic sclerosing mastoiditis with bilateral CSOM. USG Abdomen and urine examination suggested acute glomerulonephritis. Trucut biopsy of lung showed granuloma and ANCA assays showed him C ANCA positive. Treatment with prednisolone and cyclophosphamide resulted in rapid resolution of symptoms and radiological clearance. CONCLUSION: Since GPA can effect almost any organ and a high degree of suspicion should be maintained in any multisystemic disease. Rapid work up with biopsy and ANCA Assay and early treatment with immunosuppressants will prevent irreversible organ damage.
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