Polyps, grommets and eosinophilic granulomatosis with polyangiitis

Abstract

The co-presence of nasal polyps and resistant otitis media with effusion should raise the possibility of eosinophilic granulomatosis with polyangiitis.

Updates in antineutrophil cytoplasmic antibody (ANCA)‐associated vasculitis for the ENT surgeon

“…Recurrent, persistent OME with highly viscous effusions, in the presence of polyps and asthma, should further raise suspicion of EGPA. 43 Analysis of 383 EGPA patients in a French cohort described the most common manifestations of EGPA at diagnosis as (excluding ENT and lung involvement): Weight loss (49.3% -mean of 7.8kg lost), fever (38.9%), myalgia (38.9%), arthralgia (29.8%), neurological symptoms (55.1% -predominantly peripheral neuropathy or mononeuritis multiplex). 37 Thus, patients with CRS, asthma and systemic constitutional symptoms (fever/weight loss/arthralgia) or neuropathy warrant particularly careful investigation and monitoring.…”

“…Nasal polyposis with adult‐onset asthma should be an indication to check ANCA and blood eosinophil levels, 42 particularly in the presence of refractory disease. Recurrent, persistent OME with highly viscous effusions, in the presence of polyps and asthma, should further raise suspicion of EGPA 43 …”

Early ENT Manifestations in Eosinophilic Granulomatosis with Poliangioitis: Results from Our Cohort Group and Literature Review

“…Thus, the co-existing presence of nasal polyps and resistant OME should raise the possibility of EGPA. The pathophysiology of EGPA indicates that initially rhinological manifestations are the main symptoms, and recognition of nasal polyposis and OME together may lead to earlier referral and subsequent diagnosis of the disease given that the pulmonary manifestations are frequently quiescent [14].…”

“…Otitis media, sensorineural hearing loss, mastoiditis and facial nerve palsies have been reported by the Goldfarb J M et al systematic review [13]. In addition, in the 2018 Irish Study, sixteen patients were affected by otitis media with effusion (OME) before receiving EGPA diagnosis [14]. In a more recent systematic review on the diagnosis, treatment, and management of patients with otologic manifestations of EGPA, a systematic search for relevant published literature in PubMed, Cochrane Library, and EMBASE databases was done: Hearing loss and middle ear effusion were the most common presentation in EGPA [18].…”

Diagnosis of EGPA Syndrome in a Patient With Chronic Polypoid Rhinosinusitis Presenting as Loeffler Syndrome

“…Ear, nose, and throat manifestations of the condition include allergic rhinitis, nasal obstruction, recurrent rhinosinusitis, nasal polyposis, otitis media with effusion, progressive sensorineural hearing loss, and facial nerve palsy. 3 The involvement of the nasal sinus area is so frequent that it represents 1 of the 6 diagnostic criteria. 2 The EGPA follows a chronological evolution in which 3 phases can be distinguished: the first is asthma with or without allergic rhinitis; the second is eosinophilia in the peripheral blood and eosinophilic infiltration in tissues (with an appearance similar to Loeffler syndrome), and the third is vasculitic infiltration with involvement of the lung, heart, peripheral nervous system, liver, lymph nodes, muscles, and skin.…”