Abstract
IntroductionWegener's Granulomatosis is a vasculitis of uncertain aetiology. Affected patients usually present with disease of the respiratory and renal tracts. Classic symptoms and clinical findings, together with serology titres positive for anti-neutrophil cytolplasmic antibody against proteinase 3 confirm the diagnosis. Wegener's Granulomatosis can occasionally involve other organs, but solitary parotid gland disease is uncommon; patients generally also have systemic disease.Case PresentationWe report a case of Wegener's Granulomatosis in a 69-year-old Caucasian female presenting initially with an isolated parotid abscess and only subsequently developing nasal, paranasal sinus and respiratory symptoms. We describe the clinical course, diagnostic difficulties, imaging and histopathology of this case.ConclusionMajor salivary gland infection is not an uncommon ENT disorder, but the clinician should be wary of the patient who fails to respond appropriately to adequate therapy. In such cases a differential diagnosis of Wegener's Granulomatosis should be considered, as early recognition and treatment of this potentially fatal disease is paramount.
Highlights
Wegener's Granulomatosis is a vasculitis of uncertain aetiology
Case Presentation: We report a case of Wegener's Granulomatosis in a 69-year-old Caucasian female presenting initially with an isolated parotid abscess and only subsequently developing nasal, paranasal sinus and respiratory symptoms
Wegener's Granulomatosis (WG) usually presents as a triad of airway necrotising granulomas, systemic vasculitis and focal necrotising glomerulonephritis
Summary
Major salivary gland infection is not an uncommon ENT disorder, but the clinician should be wary of the patient who fails to respond appropriately to adequate therapy. In such cases a differential diagnosis of WG should be considered, as early, appropriate treatment is paramount in preventing significant morbidity or mortality. CRP: C reactive protein; cANCA PR3: anti-neutrophil cytoplasmic antibody against proteinase 3; WCC: white cell count; ENT: ear, nose and throat
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