- Nasal mucosa/upper respiratory tract, lungs - w/25% GPA affecting respiratory tract only (limited GPA)
- Peripheral nerves
- Small-to-medium vessel vasculitis
- F, c, sweats, fatigue
- Recurrent nasal or sinus congestion, nasal d/c, bleeding
- Cough, wheezing, SOB, DOE, hemoptysis
- Ear pain, discharge, decreased hearing
- Myalgias, arthralgias
- Peripheral nerve involvement--> extremity numbness, pain, and/or weakness
- Eye pain, redness, bulging, ophthalmoplegia
- Lab evidence glomerulonepthritis
- Often delays in dx as GPA is unusual→ treatedfor more common infectious or inflammatory processes (e.g. sinusitis, bronchitis, pneumonia, otitis)
- Nose: nasal mucosal erythema, edema, discharge or ulcer, nasal septum perforation, saddle nose deformity
- Ear: cartilage redness, swelling, pain, senorineural or conductive hearing loss, middle ear effusion
- Pulmonary: focal lung findings; findings c/w ILD
- Skin: papable purpura (vasculitis)
- Eyes: red eye (scleritis, uveitis), proptosis, ophthalmoplegia
- Joints: arthritis
- Peripheral neuropathy related: decreased distal sensation, weakness, diminished reflexes
- W/Renal involvement: UA + RBCs, protein; Urine microscopy w/rbc casts, dysmorphic RBCs
- Serum: decrease in GFR; often + c-anca
- PFTs - typically obstructive but can be restrictive if ILD
- Definitive dx typically requires bx